Sequential Gn-RH superagonist and medroxyprogesterone acetate treatment of uterine leiomyomata.
A group of 48 women with symptomatic leiomyomata were treated during 6 months with the short-acting Gn-RH superagonist analog buserelin. The first (group C) was followed up for an additional six months of no medication. The second (group M) was treated for 6 additional months with medroxyprogesterone acetate (MPA) at doses decreasing from 200 to 25 mg/day. Buserelin therapy significantly decreased uterine size (P less than 0.001) in all patients, the average final volume being 48.5% of the original (from 262 +/- 147 ml to 127 +/- 85.4 ml). In group C there was a significant (P less than 0.001) re-growth during the post-treatment observation period (from 120 +/- 81.0 ml to 198 +/- 77.2 ml); a significant (P less than 0.01) re-growth was also observed in group M during MPA medication (from 132 +/- 77.2 ml to 170 +/- 96.0 ml). The agonist had also a marked effect on fibroids: on average they decreased from 75.1 +/- 74.3 ml to 24.7 +/- 23.3 ml (P less than 0.025). In group C during the post-buserelin period of observation without treatment, there was a significant re-growth from 23.7 +/- 21.6 ml to 47.7 +/- 27.5 ml (P less than 0.001), whereas in group M treatment with MPA prevented any significant re-growth (from 25.6 +/- 24.8 to 30.6 +/- 32.9 ml; P greater than 0.3).
Benagiano
G
G
First Institute of Obstetrics and Gynecology, University La Sapienza, Roma, Italy.
Morini
A
A
Aleandri
V
V
Piccinno
F
F
Primiero
F M
FM
Abbondante
G
G
Elkind-Hirsch
K
K
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002064:Buserelin / Q000008:administration & dosage; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000031:analogs & derivatives; D017258:Medroxyprogesterone Acetate; D013997:Time Factors; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*
D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone; D002064:Buserelin