Inhibition of disease flare with diethylstilbestrol diphosphate and chlormadinone acetate administration for two weeks prior to slow-releasing leuprolide acetate in prostatic cancer patients.
To determine whether administration of estrogen or gestagen prior to luteinizing hormone-releasing hormone (LH-RH) agonist prevents disease flare in prostate cancer patients, we pretreated the patients with either diethylstilbestrol diphosphate (DES-P) 300 mg daily (N = 17) or chlormadinone acetate (CMA) 100 mg daily (N = 16) or none (N = 16) for two weeks before the initial injection of leuprolide acetate (L). Blood samples for prostatic specific antigen (PSA), testosterone (T), and luteinizing hormone were collected before CMA and DES-P administration, before and at 2, 7, 14, 28, 56, and 84 days after the first administration of leuprolide. The treatment with DES-P and CMA prior to LH-RH agonist induced an early decline of PSA. The mean PSA level showed no significant secondary rise in those patients with pretreatment after L administration. In the patients pretreated with DES-P or CMA, the mean serum T level never exceeded the pretreatment baseline after L administration. On the other hand, in the patients without DES-P or CMA, both serum T and PSA levels increased after the first administration of L. These results clearly demonstrate that pretreatment with DES-P 300 mg daily or CMA 100 mg daily for 2 weeks is quite effective to prevent disease flare after the first administration of L in patients with prostatic cancer.
Ohuchi
H
H
Department of Urology, Yokohama City University.
Noguchi
K
K
Kinoshita
Y
Y
Hosaka
M
M
Kawasaki
C
C
Miura
T
T
Kondo
I
I
Harada
M
M
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D012898:Autacoids; D002715:Chlormadinone Acetate / Q000008:administration & dosage*; D004054:Diethylstilbestrol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011292:Premedication; D045167:Progesterone Congeners / Q000008:administration & dosage*; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000517:prevention & control; D013739:Testosterone / Q000097:blood
D018931:Antineoplastic Agents, Hormonal; D012898:Autacoids; D045167:Progesterone Congeners; D002715:Chlormadinone Acetate; D013739:Testosterone; D004054:Diethylstilbestrol; D007986:Luteinizing Hormone; C004955:fosfestrol; D017430:Prostate-Specific Antigen; D016729:Leuprolide