Frauenheilkunde up2date 2013; 7(5): 375-385
DOI: 10.1055/s-0033-1346683
Gynäkologische Endokrinologie und Reproduktionsmedizin
Georg Thieme Verlag KG Stuttgart · New York

Hormontherapie bei Patientinnen mit gynäkologischen Malignomen

Claus Lattrich
,
Susanne Schüler
,
Olaf Ortmann
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
16. Oktober 2013 (online)

Kernaussagen

Eine HT ist nach Behandlung einer Brust-, Endometrium- oder Ovarialkarzinomerkrankung grundsätzlich kontraindiziert. In Ausnahmefällen und nach individueller Beratung der Patientin über mögliche Risiken und Nutzen einer HT kann sie im Einzelfall zur Therapie klimakterischer Beschwerden erwogen werden. Die Patientin sollte auf jeden Fall über den möglichen Einsatz nichthormoneller Therapien aufgeklärt werden. Besonderes Augenmerk ist der Selbstmedikation der Patientin zu widmen, da komplementäre oder alternative Therapieansätze bei der Karzinombehandlung kontraindiziert oder unsicher sein können.

 
  • Literatur

  • 1 Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. S3-Leitlinie „Hormontherapie in der Peri- und Postmenopause“. http://www.awmf.org/leitlinien/detail/ll/015-062.html
  • 2 The North American Menopause Society. Menopause Practice: A Clinicianʼs Guide. 4th ed. Mayfield Heights, OH/USA: NAMS; 2010
  • 3 Ash P. The influence of radiation on fertility in man. Br J Radiol 1980; 53: 271-278
  • 4 Creasman WT, Henderson D, Hinshaw W, Clarke-Pearson DL. Estrogen replacement therapy in the patient treated for endometrial cancer. Obstet Gynecol 1986; 67: 326-330
  • 5 Ploch E. Hormonal replacement therapy in patients after cervical cancer treatment. Gynecol Oncol 1987; 26: 169-177
  • 6 Lee RB, Burke TW, Park RC. Estrogen replacement therapy following treatment for stage I endometrial carcinoma. Gynecol Oncol 1990; 36: 189-191
  • 7 Gerbaldo D, Ferraiolo A, Croce S et al. Endometrial morphology after 12 months of vaginal oestriol therapy in post-menopausal women. Maturitas 1991; 13: 269-274
  • 8 Eeles RA, Tan S, Wiltshaw E et al. Hormone replacement therapy and survival after surgery for ovarian cancer. Br Med J 1991; 302: 259-262
  • 9 Habeshaw T, Pinion SB. The incidence of persistent functioning endometrial tissue following successful radiotherapy for cervical carcinoma. Int J Gynecol Cancer 1992; 2: 332-335
  • 10 DiSaia PJ, Grosen EA, Kurosaki T et al. Hormone replacement therapy in breast cancer survivors: a cohort study. Am J Obstet Gynecol 1996; 174: 1494-1498
  • 11 Persson I. Cancer risk in women receiving estrogen-progestin replacement therapy. Maturitas 1996; 23 (Suppl.) S37-S45
  • 12 Chapman JA, DiSaia PJ, Osann K et al. Estrogen replacement in surgical stage I and II endometrial cancer survivors. Am J Obstet Gynecol 1996; 175: 1195-1200
  • 13 Vassilopoulou-Sellin R, Theriault R, Klein MJ. Estrogen replacement therapy in women with prior diagnosis and treatment for breast cancer. Gynecol Oncol 1997; 65: 89-93
  • 14 Natrajan PK, Soumakis K, Gambrell jr. RD. Estrogen replacement therapy in women with previous breast cancer. Am J Obstet Gynecol 1999; 181: 288-295
  • 15 Vassilopoulou-Sellin R, Asmar L, Hortobagyi GN et al. Estrogen replacement therapy after localized breast cancer: clinical outcome of 319 women followed prospectively. J Clin Oncol 1999; 17: 1482-1487
  • 16 Guidozzi F, Daponte A. Estrogen replacement therapy for ovarian carcinoma survivors: a randomized controlled trial. Cancer 1999; 86: 1013-1018
  • 17 Beckmann MW, Jap D, Djahansouzi S et al. Hormone replacement therapy after treatment of breast cancer: effects on postmenopausal symptoms, bone mineral density, and recurrence rates. Oncology 2001; 60: 199-206
  • 18 OʼMeara ES, Rossing MA, Daling JR et al. Hormone replacement therapy after a diagnosis of breast cancer in relation to recurrence and mortality. J Natl Cancer Inst 2001; 93: 754-762
  • 19 Col NF, Hirota LK, Orr RK et al. Hormone replacement therapy after breast cancer: a systematic review and quantitative assessment of risk. J Clin Oncol 2001; 19: 2357-2363
  • 20 Suriano KA, McHale M, McLaren CE et al. Estrogen replacement therapy in endometrial cancer patients: a matched control study. Obstet Gynecol 2001; 97: 555-560
  • 21 Ursic-Vrscaj M, Bebar S, Zakelj MP. Hormone replacement therapy after invasive ovarian serous cystadenocarcinoma treatment: the effect on survival. Menopause 2001; 8: 70-75
  • 22 Anderson GL, Limacher M, Assaf AR et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Womenʼs Health Initiative randomized controlled trial. J Am Med Assoc 2004; 291: 1701-1712
  • 23 Wang PH, Chang C. Androgens and ovarian cancers. Eur J Gynecol Oncol 2004; 25: 157-163
  • 24 Holmberg L, Anderson H. HABITS (hormonal replacement therapy after breast cancer – is it safe?), a randomised comparison: trial stopped. Lancet 2004; 363: 453-455
  • 25 von Schoultz E, Rutqvist LE. Menopausal hormone therapy after breast cancer: the Stockholm randomized trial. J National Cancer Inst 2005; 97: 533-535
  • 26 Hickey M, Saunders CM, Stuckey BG. Management of menopausal symptoms in patients with breast cancer: an evidence-based approach. Lancet Oncol 2005; 6: 687-695
  • 27 Rebbeck TR, Friebel T, Wagner T et al. Group Prose Study: 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 2005; 23: 7804-7810
  • 28 Barakat RR, Bundy BN, Spirtos NM 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 2006; 24: 587-592
  • 29 Mascarenhas C, Lambe M, Bellocco R et al. Use of hormone replacement therapy before and after ovarian cancer diagnosis and ovarian cancer survival. Int J Cancer 2006; 119: 2907-2915
  • 30 Kotsopoulos J, Lubinski J, Neuhausen SL et al. Hormone replacement therapy and the risk of ovarian cancer in BRCA1 and BRCA2 mutation carriers. Gynecol Oncol 2006; 100: 83-88
  • 31 Kendall A, Dowsett M, Folkerd E, Smith I. Caution: Vaginal estradiol appears to be contraindicated in postmenopausal women on adjuvant aromatase inhibitors. Ann Oncol/ESMO 2006; 17: 584-587
  • 32 Nelson HD, Vesco KK, Haney E et al. Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis. J Am Med Assoc 2006; 295: 2057-2071
  • 33 de Bock GH, van der Hage JA, Putter H et al. Isolated loco-regional recurrence of breast cancer is more common in young patients and following breast conserving therapy: long-term results of European Organisation for Research and Treatment of Cancer studies. Eur J Cancer 2006; 42: 351-356
  • 34 Beral V, Bull D, Green J, Reeves G. Ovarian cancer and hormone replacement therapy in the Million Women Study. Lancet 2007; 369: 1703-1710
  • 35 Holmberg L, Iversen OE, Rudenstam CM et al. Increased risk of recurrence after hormone replacement therapy in breast cancer survivors. J National Cancer Instit 2008; 100: 475-482
  • 36 Kenemans P, Bundred NJ, Foidart JM et al. Safety and efficacy of tibolone in breast-cancer patients with vasomotor symptoms: a double-blind, randomised, non-inferiority trial. Lancet Oncol 2009; 10: 135-146
  • 37 Morch LS, Lokkegaard E, Andreasen AH et al. Hormone therapy and ovarian cancer. J Am Med Assoc 2009; 302: 298-305
  • 38 Rada G, Capurro D, Pantoja T et al. Non-hormonal interventions for hot flushes in women with a history of breast cancer. Cochrane Database Syst Rev 2010; (9) CD004923
  • 39 Walker EM, Rodriguez AI, Kohn B et al. Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol 2010; 28: 634-640
  • 40 Chuery AC, Speck NM, de Moura KF et al. Efficacy of vaginal use of topical estriol in postmenopausal women with urogenital atrophy. Clin Experiment Obstet Gynecol 2011; 38: 143-145
  • 41 Pfeiler G, Glatz C, Konigsberg R et al. Vaginal estriol to overcome side-effects of aromatase inhibitors in breast cancer patients. Climacteric 2011; 14: 339-344
  • 42 Griesser H, Skonietzki S, Fischer T et al. Low dose estriol pessaries for the treatment of vaginal atrophy: a double-blind placebo-controlled trial investigating the efficacy of pessaries containing 0.2 mg and 0.03 mg estriol. Maturitas 2012; 71: 360-368
  • 43 Haring J, Schuler S, Lattrich C et al. Role of estrogen receptor beta in gynecological cancer. Gynecol Oncol 2012; 127: 673-676
  • 44 Moegele M, Buchholz S, Seitz S, Ortmann O. Vaginal estrogen therapy in postmenopausal breast cancer patients treated with aromatase inhibitors. Arch Gynecol Obstet 2012; 285: 1397-1402
  • 45 Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013; 63: 11-30
  • 46 Fahlen M, Fornander T, Johansson H et al. Hormone replacement therapy after breast cancer: 10 year follow up of the Stockholm randomised trial. Eur J Cancer 2013; 49: 52-59
  • 47 Maligne Ovarialtumore: Diagnostik, Therapie und Nachsorge. http://www.awmf.org/leitlinien/detail/ll/032-035OL.html Stand: 30.06.2013
  • 48 Sekar H, Singhal T, Holloway D, Rymer J. The use of hormone therapy and its alternatives in women with a history of hormone dependent cancer. Menopause Int 2013; 19: 37-42