Comparative Efficacy and Safety Profiles of Goserelin and Leuprolide in Postmenopausal Breast Cancer Patients Receiving Adjuvant Endocrine Therapy: A Retrospective Cohort Study

Purpose Although both goserelin and leuprolide belong to although different gonadotropin-releasing hormone (GnRH) agonists, the different molecular structures produce different efficacy and adverse effects. This study aimed to explore the clinical efficacy and adverse effects of goserelin and leuprolide in the postoperative adjuvant treatment of premenopausal breast cancer. Methods A total of 215 young cancer patients initially receiving adjuvant chemotherapy with TAM combined with GnRH agonists were recruited in this study; 187 female patients were finally included based on the inclusion and exclusion criteria. These patients were randomly assigned to the leuprolide group (n = 90) or goserelin group (n = 97) according to the type of GnRH agonist, with no statistically significant differences in baseline demographic characteristics and cancer-related characteristics between the two groups, indicating well-performed randomization. Compare treatment outcomes (estrogen levels and cancer embryonic expression levels) and adverse reactions (liver function and thyroid function expression levels) between the two patient groups after treatment. Results After 6 months of combined adjuvant therapy, there were no significant differences between the two groups in the rate of significant estrogen reduction (56.67% in the leuprolide group vs. 57.73% in the goserelin group, with the most prominent decrease in estradiol) or the normalization rate of CEA (93.33% in the leuprolide group vs. 92.78% in the goserelin group). However, the abnormal rate of liver function in the leuprolide group (30%) was significantly higher than that in the goserelin group (13.4%), particularly with the normalization rate of AST in the leuprolide group (85.56%) being significantly lower than that in the goserelin group (96.61%); in contrast, the normalization rate of thyroid function parameters (88.89%) and TSH (93.33%) in the leuprolide group were both significantly higher than those in the goserelin group (76.29% and 83.51%, respectively). Conclusions Leuprolide and Goserelin combined with adjuvant tamoxifen therapy demonstrate comparable efficacy in young female breast cancer patients. Leuprolide carries a risk of liver function impairment, while Goserelin may cause thyroid damage. These findings provide a theoretical basis for individualized clinical treatment.