Ovarian protection and safety of gonadotropin-releasing hormone agonist after cervical cancer surgery: systematic review and meta-analysis

BACKGROUND: This meta-analysis was performed using Stata (15.0), and sought to systematically evaluate the domestic application value of the gonadotropin-releasing hormone agonist (GNRH-a) after cervical cancer, and explore its protective effect on the ovaries during chemotherapy. In many studies, the effectiveness and safety of GNRH-a are not consistent, and there is great controversy. Therefore, it is very important to systematically evaluate the protection and safety of GNRH-a after cervical cancer surgery. METHODS: PubMed, Cochrane Library, and Web of Science databases were systematically searched to retrieve articles on domestic trials examining the use of GNRH-a treatment in cervical cancer patients, published from January 2014 to January 2021, which were reviewed according to the inclusion and exclusion criteria of this study. The meta-analysis of the included study data was conducted using Stata 15.0. RESULTS: In total, 10 articles were included in the meta-analysis, comprising 579 ovarian-reserved cervical cancer subjects, all of whom received 4–6 standardized courses of PC (Paclitaxel + Cisplatin) chemotherapy. The following statistically significant differences were found: bovine follicle stimulating hormone [odds ratio (OR) =1.82, 95% confidence interval (CI): 1.38–2.38; P<0.0001], bovine estrogen 2 (OR =2.39, 95% CI: 1.69–3.37; P<0.00001), anti-Mullerian hormone (OR =2.39, 95% CI: 1.71–3.34; P<0.00001), and bovine antral follicle count (OR =2.11, 95% CI: 1.49–2.99; P<0.0001); but there is no statistically significant difference incidence of coincidences (OR =0.80, 95% CI: 0.49–1.31; P=0.38). CONCLUSIONS: The use of GNRH-a in cervical cancer patients receiving the PC chemotherapy regimen plays a significant role in protecting ovarian function.