Mitigating Risk of Premature Ovarian Insufficiency Using Adjunct Chinese Herbal Medicines: A Nested Patient-Control Study in Female Cancer Patients with Chemotherapy.

Purpose: Premature ovarian insufficiency (POI) is a common late effect of chemotherapy among survivors of adolescent and young-adult cancer (AYAC). Given on the widespread use of Chinese herbal medicine (CHM) in restoring individual health, we performed a cohort-based nested patient-control study with the aim of exploring the effect of blending CHM into routine care on the reduction of chemotherapy-induced POIrisk among females with AYAC. Methods: Females aged 20-39 years with a newly-diagnosed AYAC and being free of POI between 2002 and 2010 were recruited from a population-based claims data. From these enrollees, we identified those with POI occurring after AYAC onset by the end of 2013 (n = 1040). Corresponding controls were randomly selected from the remaining subjects using a pair-matched approach. We then adopted conditional logistic regression to clarify the association between CHM use and POI risk, shown as 95% confidence intervals (CI) and adjusted odds ratios (AOR). Results: Patients who revived CHM in addition to standard treatment towards AYAC experienced a substantial lower risk of POI than did those who did not use CHM (AOR, 0.16; 95% CI, 0.13-0.19). Importantly, initiating CHM treatment within the first three years after AYAC onset had the greatest benefit, with a lower risk of POI by 92%. Conclusion: The present study revealed that embedding CHM into routine care of AYAC acted to prevent subsequent POI incident, implying that interdisciplinary collaboration and timely treatment planning should be emphasized to reduce the chance of POI onset.