臨床婦人科産科72巻2号

2018年03月発行

今月の臨床 ホルモン補充療法ベストプラクティス─いつから始める？　いつまで続ける？　何に注意する？

悪性腫瘍との関連

がんサバイバーに対するHRT

著者： 佐々木浩¹

所属機関： ¹大阪医科大学産婦人科

ページ範囲：P.278 - P.283

文献概要

●子宮頸がん術後のHRTは扁平上皮癌においては問題ないと考えられるが，腺癌に関してはエビデンスが乏しいため十分なインフォームド・コンセントが必要である．

●子宮体がん術後のHRTは初期においては許容されるが，Ⅲ期以上の進行症例には推奨されていない．

●卵巣がん術後のHRTは進行期，組織型にかかわらず可能と考えるが，血栓症などの副作用には注意が必要である．

参考文献

1）Madalinska JB, et al : Quality-of-life effects of prophylactic salpingo-oophorectomy versus gynecologic screening among women at increased risk of hereditary ovarian cancer. J Clin Oncol 23 : 6890─6898, 2005

2）Rocca WA, et al : Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neuro 69 : 1074─1083, 2007

3）Yoshida T, et al : Impact of surgical menopause on lipid and bone metabolism. Climacteric 14 : 445─452, 2011

4）Atsma F, et al : Postmenopausal status and early menopause as independent risk factors for cardiovascular disease : a meta-analysis. Menopause 13 : 265─279, 2006

5）Ploch E : Hormonal replacement therapy in patients after cervical cancer treatment. Gynecol Oncol 26 : 169─177, 1987

6）Lacey JV, et al : Use of hormone replacement therapy and adenocarcinomas and squamous cell carcinomas of the uterine cervix. Gynecol Oncol 77 : 149─154, 2000

7）Singh P, et al : Hormone replacement after gynaecological cancer. Maturitas 65 : 190─197, 2010

8）Guidozzi F : Estrogen therapy in gynecological cancer survivors. Climacteric 16 : 611─617, 2013

9）Takeshima N, et al : Ovarian metastasis in endometrial carcinoma. Gynecol Oncol 70 : 183─187, 1998

10）Boronow RC, at al : Surgical staging in endometrial cancer : clinical-pathologic findings of a prospective study. Obstet Gynecol 63 : 825─832, 1984

11）Rocca WA, et al : Survival patterns after oophorectomy in premenopausal women : a population-based cohort study. Lancet Oncol 7 : 821─828, 2006

12）Barakat RR, et al : Randomized double-blind trial of estrogen replacement therapy versus placebo in stage I or II endometrial cancer : a Gynecologic Oncology Group Study. J Clin Oncol 24 : 587─592, 2006

13）The NAMS 2017 Hormone Therapy Position Statement Advisory Panel : The 2017 hormone therapy position statement of The North American Menopause Society. Menopause 24 : 728─753, 2017

14）Li D, et al : Postoperative hormone replacement therapy for epithelial ovarian cancer patients : a systematic review and meta analysis. Gynecol Oncol 139 : 355─362, 2015

15）Pergialiotis V, et al : Hormone therapy for ovarian cancer survivors : systematic review and meta-analysis. Menopause 23 : 335─342, 2016

16）Gershenson DM, et al : Hormonal Maintenance Therapy for Women With Low-Grade Serous Cancer of the Ovary or Peritoneum. J Clin Oncol 35 : 1103─1111, 2017

17）Col NF, et al : Menopausal hormone therapy after breast cancer : a meta-analysis and critical appraisal of the evidence. Breast Cancer Res 7 : R535─R540, 2005

18）Holmberg L, et al : HABITS Study Group. Increased risk of recurrence after hormone replacement therapy in breast cancer survivors. J Natl Cancer Inst 100 : 475─482, 2008

19）Breast cancer and hormone replacement therapy : collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 350 : 1047─1059, 1997

20）Nancie MS, et al : BRCA1 and BRCA2 Hereditary Breast and Ovarian Cancer. Gene Reviews, 2016

21）Rebbeck TR, et al : Effect of short-term hormone replacement therapy on breast cancer risk reduction after bilateral prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers : the PROSE Study Group. J Clin Oncol 23 : 7804─7810, 2005

22）Domchek SM, et al : PROSE Consortium : Is hormone replacement therapy（HRT）following risk-reducing salpingo-oophorectomy（RRSO）in BRCA1（B1）- and BRCA2（B2）-mutation carriers associated with an increased risk of breast cancer? J Clin Oncol 2011 ; 29（suppl） : Abstract 1501, 2011

23）Kotsopoulos J, et al : Hormone replacement therapy after menopause and risk of breast cancer in BRCA1 mutation carriers : a case-control study. Breast Cancer Res Treat 155 : 365─373, 2016