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中华妇幼临床医学杂志(电子版) ›› 2015, Vol. 11 ›› Issue (04) : 429 -432. doi: 10.3877/cma.j.issn.1673-5250.2015.04.001

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肿瘤生殖学及宫颈癌治疗中生理和生育功能保护问题
崔恒*(), 程洪艳, 鹿群   
  1. 100044 北京大学人民医院妇科肿瘤中心
    100044 北京大学人民医院生殖中心
  • 收稿日期:2015-06-20 出版日期:2015-08-01
  • 通信作者: 崔恒

Offer protection to individual physiological and reproductive function in treatment of cervical cancer with view and technique of oncofertility

Heng Cui*(), Hongyan Cheng, Qun Lu   

  1. Center of Gynecological Cancer, People's Hospital, Beijing University, Beijing 100044, China
    Center of Reproductive, People's Hospital, Beijing University, Beijing 100044, China
  • Received:2015-06-20 Published:2015-08-01
  • Corresponding author: Heng Cui
引用本文:

崔恒, 程洪艳, 鹿群. 肿瘤生殖学及宫颈癌治疗中生理和生育功能保护问题[J/OL]. 中华妇幼临床医学杂志(电子版), 2015, 11(04): 429-432.

Heng Cui, Hongyan Cheng, Qun Lu. Offer protection to individual physiological and reproductive function in treatment of cervical cancer with view and technique of oncofertility[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(04): 429-432.

随着年轻肿瘤患者的发病率和治愈率均不断提高,以及手术和放化疗常带来不同程度的生育功能损害,保留和保存年轻肿瘤患者的生育功能,成为越来越迫切的需求,肿瘤生殖学(oncofertility)应运而生。肿瘤生殖学是在降低和预防肿瘤复发及由此导致患者死亡的风险,延长患者生存期,甚至治愈癌症的同时,减轻治疗干预方法本身导致的不孕风险,为患者提供选择具有更高生活质量的机会。女性肿瘤患者保存和保护生育功能的主要方法包括:卵巢移位术/性腺屏蔽、在化疗中应用促性腺激素释放激素类似物(GnRHa)保护卵巢功能、胚胎冷冻、卵子冷冻、卵巢组织/卵巢冷冻与移植、干细胞的诱导分化、人工卵巢工程及子宫移植等。宫颈癌治疗中生育功能保留方法包括宫颈广泛切除术(RT)、宫颈锥切术等,此外,保留神经的广泛性子宫切除术和阴道延长术等,也可在宫颈癌治疗中进行生理功能保护,在有效控制肿瘤的同时,使患者生存质量提高。

The incidence and the cure rate of young cancer patients are rising, while surgery, radiation and chemotherapy often bring different degrees of damage to the reproductive function. It becomes more and more urgent to keep and preserve the reproductive functions of young cancer patients. Oncofertility arises at the historic moment. Oncofertility is to reduce the infertility risk caused by treatment and intervention methods, providing opportunities for the choice of patients to have a higher quality of life on the base of reducing and preventing the risk of tumor recurrence and the resulting death, prolonging patients' survival time, and even a cure for cancer. The main methods to save and protect the reproductive function of women with tumors include ovarian transposition/gonad shielding, application of gonadotropin-releasing hormone analogues (GnRHa) to protect ovarian function in chemotherapy, embryo freezing, egg freezing, ovarian tissue/ovary cryopreservation and transplantation, stem cell differentiation, artificial ovary, uterus transplant engineering, etc.. Methods of preservation of reproductive function in cervical cancer treatment include cervical radical trachelectomy (RT), conization of cervix, etc.. In addition, radical hysterectomy can keep nerve and vagina lengthening, also may carry on the protection of physiological function in cervical cancer treatment, in effective control of tumor at the same time improving the quality of patients' life.

表1 单一制剂或联合化疗方案作为早期乳腺癌辅助治疗所导致患者永久性闭经的风险评估
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