goserelin and fosfestrol

In our institution, rotational 3D-conformal radiation therapy (also called conformation therapy) has been applied since the late 1970s to conform the target volume of high-dose radiation to the cancerous tissue while minimizing radiation to the surrounding normal tissues. This technique has been used most commonly to treat prostate cancers in combination with hormonal therapy. The results of Stage B2/C prostate cancer treated with this method were analyzed.. Between 1987 and 1997, 33 cases of prostate cancer were definitively treated with this method: 9 Stage B2 tumors and 24 Stage C tumors. Of these 33 tumors, 3 were well differentiated, 18 were moderately differentiated, and 12 were poorly differentiated. The average patient age was 75.6 years. The median pretreatment PSA value was 23.8 ng/ml. The total radiation dose ranged from 60 Gy to 70 Gy (average: 63.5 Gy) with conventional fractionation. Hormone therapy was administered permanently; the primary hormonal agent was diethylstilbestrol phosphate.. The overall survival rate after 5 years was 58.2% and that after 10 years was 29.6%. The biochemical relapse-free rate after 5 years was 87.0% and that after 10 years was still 87.0%. There were 4 cases of biochemical failure, but no cases of death from prostate cancer. Stage, differentiation, and pretreatment PSA value were not prognostic factors. One of the 2 cases with delayed complications was a case of RTOG Grade 3 gastrointestinal complication.. Rotational 3D-conformal radiation therapy combined with hormone therapy might be promising for the treatment of prostate cancer.

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Chemotherapy, Adjuvant; Chlormadinone Acetate; Diethylstilbestrol; Disease-Free Survival; Flutamide; Follow-Up Studies; Gastrointestinal Diseases; Goserelin; Humans; Imaging, Three-Dimensional; Japan; Life Tables; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Prostatic Neoplasms; Radiation Injuries; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Conformal; Retrospective Studies; Rotation; Survival Analysis; Treatment Outcome; Urination Disorders

Topics: Buserelin; Castration; Chorionic Gonadotropin; Cosyntropin; Dexamethasone; Diethylstilbestrol; Estrogens; Goserelin; Hormones; Humans; Luteinizing Hormone; Male; Prostatic Neoplasms; Testosterone

The objective of this study was to elucidate the mechanism underlying the further suppression of serum testosterone (T) by diethylstilbestrol diphosphate (DES-DP) in patients with prostate cancer refractory to hormonal treatment. These patients received an LHRH agonist with or without a non-steroidal androgen-receptor blocker or a gestagen before DES-DP. We measured serum levels of total and free T, dihydrotestosterone (DHT), estradiol (E2), dehydroepiandrosterone sulfate (DHEA-S), dehydroepiandrosterone (DHEA), androstenedione, cortisol, aldosterone before and during intravenous administration of high doses of DES-DP (500 or 1000 mg/day). DES-DP administration suppressed the serum levels of FSH (p=0.04) and total T (p=0.02), and eliminated free T (p=0.04) and E2 (p=0.04) from serum, while reducing serum DHEA-S to approximately two-thirds of the pretreatment level (p=0.03). In contrast, serum levels of SHBG (p=0.02) and cortisol (p=0.02) were markedly increased after DES-DP administration. The latter had no significant effect on serum levels of LH, DHT, ACTH, 17alpha-hydroxypregnenolone, 17alpha-hydroxyprogesterone, DHEA, androstenedione, or aldosterone. The results suggest that the potent suppression of circulating total T by DES-DP is caused, in part, by the inhibitory effect of DES-DP on serum DHEA-S level. In most patients, high-dose DES-DP treatment completely suppressed the serum level of free T, while possibly elevating serum SHBG and decreasing serum total T. The mechanisms that maintain the serum level of serum DHT during DES-DP treatment require further elucidation.

Topics: Aged; Aged, 80 and over; Androgen Antagonists; Antineoplastic Agents; Chlormadinone Acetate; Dehydroepiandrosterone Sulfate; Diethylstilbestrol; Drug Resistance, Neoplasm; Estradiol; Follicle Stimulating Hormone; Goserelin; Hormones; Humans; Hydrocortisone; Leuprolide; Male; Middle Aged; Progesterone Congeners; Prostatic Neoplasms; Sex Hormone-Binding Globulin; Testosterone

In the light of a case of left orbital metastasis, constituting the presenting sign of prostatic cancer in a 60-year-old man, the authors emphasize the rarity of this site, despite the high frequency of bone metastases in this disease. They discuss the diagnostic methods and stress the need for urgent treatment to save ocular function.

Topics: Adenocarcinoma; Antineoplastic Agents; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Diethylstilbestrol; Emergencies; Goserelin; Humans; Injections, Intravenous; Male; Methylprednisolone Hemisuccinate; Middle Aged; Orbital Neoplasms; Prostatic Neoplasms; Vision, Ocular