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Hormonersatztherapie nach Mamma- und Ovarialkarzinom

Hormone replacement therapy after breast and ovarian cancer

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Frauen, die an einem Mammakarzinom behandelt wurden, leiden unter dem konsekutiven Östrogenmangel einer Chemo- oder antiendokrinen Therapie. Diese Frauen würden erheblich von einer Hormonsubstitution profitieren. Die Datenlage dazu ist allerdings inkonsistent. Zahlreiche Beobachtungsstudien konnten kein erhöhtes Rezidivrisiko unter Hormonersatztherapie (HRT) zeigen, allerdings waren viele dieser Arbeiten sehr heterogen, retrospektiv und hatten eine zu geringe Fallzahl. Die wenigen prospektiven Studien suggerieren eine Erhöhung des Rezidivrisikos unter HRT. Auch das Ovarialkarzinom ist ein hormonabhängiges Malignom, weshalb eine HRT in der Peri- und Postmenopause einen Einfluss auf das Erkrankungsrisiko haben kann, insbesondere nach behandelter Erkrankung. Die Datenlage zur Wirkung einer HRT auf das Ovarialkarzinom ist dünn. Epidemiologische Studien zeigen, dass eine langfristige HRT das Ovarialkarzinomrisiko möglicherweise erhöht. Noch spärlicher sind die Daten zum Einsatz einer HRT nach Ovarialkarzinombehandlung. Zuverlässige Empfehlungen lassen sich daraus nicht ableiten. Ziel dieser Arbeit ist es, aus der aktuellen Datenlage die Frage nach der Durchführbarkeit einer HRT zu eruieren und möglicherweise neue Empfehlungen daraus zu erhalten.

Abstract

Breast cancer patients undergoing chemotherapy or anti-endocrine treatment suffer from a subsequent lack of estrogen. While these women would benefit substantially by estrogen replacement, the pertinent data are sparse and inconsistent. Observational studies have not shown an increased risk of recurrence under hormone replacement therapy (HRT); however, the studies are heterogeneous, retrospective and mostly underpowered. The few randomized prospective studies suggest an increased recurrence rate with HRT regimens. Since ovarian cancer is a hormone-related malignancy as well, HRT in perimenopausal and postmenopausal women may have an impact on ovarian cancer risk, especially after primary treatment, but data are scanty. Epidemiological studies have shown that long-term HRT might even increase the risk of ovarian cancer The data on HRT after ovarian cancer treatment are even scantier ; thus, there are no reliable recommendations. This paper reviews the current literature concerning the feasibility of HRT in order to develop new recommendations.

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  1. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    M. Thill, D. Fischer, K. Röder, D.W. Lüdders, K. Diedrich & C. Dittmer

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  1. M. Thill
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  2. D. Fischer
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  3. K. Röder
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Correspondence to M. Thill.

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Thill, M., Fischer, D., Röder, K. et al. Hormonersatztherapie nach Mamma- und Ovarialkarzinom. Gynäkologische Endokrinologie 8, 35–40 (2010). https://doi.org/10.1007/s10304-009-0330-9

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