A review of clinical evidence to assess differences in efficacy and safety of luteinizing hormone杛eleasing hormone (LHRH) agonist (goserelin) and LHRH antagonist (degarelix)

Luteinizing hormone杛eleasing hormone agonist (LHRH?A), goserelin, and antagonist, degarelix, are both indicated for the treatment of advanced prostate cancer (PCa); however, large comparative trials evaluating their efficacy and safety are lacking. In this review, we assessed the available evidence for both the drugs. Although degarelix achieves an early rapid decline in testosterone (T) and prostate?specific antigen (PSA) levels, median T and PSA levels, in addition to prostate volume and International Prostate Symptom Scores, become comparable with goserelin over the remaining treatment period. Degarelix causes no initial flare, therefore it is recommended in patients with spinal metastases or ureteric obstruction. Goserelin achieves lower PSA, improved time to progression, and better survival outcomes when administered adjunctively to radiotherapy compared with radiotherapy alone, with significant results even over long?term follow?up. The evidence supporting adjuvant degarelix use is limited. Goserelin has better injection site safety, single?step delivery, and an efficient administration schedule compared with degarelix, which has significantly higher injection site reactions and less efficient administration mechanism. There is conflicting evidence about the risk of cardiovascular disease (CVD), and caution is required when using LHRH?A in patients with preexisting CVD. There is considerable long?term evidence for goserelin in patients with advanced PCa, with degarelix being a more recent option. The available comparative evidence of goserelin versus degarelix has several inherent limitations related to study design, sample size, conduct, and statistical analyses, and hence warrants robust prospective trials and long?term follow?up.

Prostate Cancer and Androgen Deprivation Therapy: Metabolic, Cardiovascular and Psychological Side Effects.

Exposure to androgen deprivation therapy (ADT) by prostate cancer (PCa) patients is increasing, either in early-stage and in metastatic disease. Frequently, ADT becomes a long-term treatment, lasting even more than 10 years, starting with gonadotropin releasing hormone (GnRH) agonists or antagonists, until the newest hormonal treatments as Abiraterone and Enzalutamide. As a consequence, ADT related adverse events occurred. We reviewed the medical literature using Pubmed search terms “prostate cancer”, “androgen deprivation”, “metabolic syndrome”, “cardiovascular diseases” and “psychological assessment”. The search was limited to manuscripts published in English language between 1999 and 2016, preferring more recent review articles. Metabolic syndrome, diabetes and cardiovascular diseases, rather than PCa itself, are the most common causes of mortality, particularly in early stage PCa patients. All these adverse eff ects synergistically increase morbidity in patients taking ADT. Psychological-cognitive implications emerging during ADT result in a signifi cant reduction of health-related quality of life of PCa patients. ADT is associated with several adverse events, which physicians andpatients should evaluate when recommending ADT. Multidisciplinary approach, with diff erent clinicians such as Urologist, Radiotherapist, Oncologist, Endocrinologist, Cardiologist, Psychologist, is mandatory for the suitable clinical management of patients with PCa submitted to ADT.

Preparation and evaluation of a phospholipid-based injectable gel for the long term delivery of leuprolide acetaterrh

A phospholipid-based injectable gel was developed for the sustained delivery of leuprolide acetate (LA). The gel system was prepared using biocompatible materials (SPME), including soya phosphatidyl choline (SPC), medium chain triglyceride (MCT) and ethanol. The system displayed a sol state with low viscosity in vitro and underwent in situ gelation in vivo after subcutaneous injection. An in vitro release study was performed using a dialysis setup with different release media containing different percentages of ethanol. The stability of LA in the SPME system was investigated under different temperatures and in the presence of various antioxidants. In vivo studies in male rats were performed to elucidate the pharmacokinetic profiles and pharmacodynamic efficacy. A sustained release of LA for 28 days was observed without obvious initial burst in vivo. The pharmacodynamic study showed that once-a-month injection of LA-loaded SPME (SPME-LA) led to comparable suppression effects on the serum testosterone level as observed in LA solution except for the onset time. These findings demonstrate excellent potential for this novel SPME system as a sustained release delivery system for LA.

Avaliação farmacoeconômica de diferentes apresentações de Eligard® e outros análogos LHRH para supressão androgênica em pacientes com câncer de próstata avançado ou metastático / Pharmacoeconomic evaluation of Eligard® and other LHRH analogues as androgen deprivation therapy for advanced and metastatic prostate cancer

Introdução: O acetato de leuprorrelina, substância ativa do medicamento Eligard®, é um análogo sintético não peptídeo do hormônio liberador do hormônio luteinizante (LHRH) que está bem estabelecido para o tratamento de primeira linha para pacientes com câncer de próstata avançado. Diversas opções de análogos LHRH estão disponíveis no Brasil, com diferentes formulações e periodicidade entre as aplicações. O Eligard® 45mg, de administração semestral, pode trazer vantagens clínicas e econômicas pela sua maior duração de efeito. Objetivo: Realizar uma avaliação econômica comparando diferentes apresentações de Eligard® e outros análogos LHRH no tratamento de pacientes com câncer de próstata avançado ou metastático no Brasil, sob as perspectivas do SUS, serviços públicos e saúde suplementar. Método: Modelos de Markov foram desenvolvidos para avaliar custos e desfechos em coortes de pacientes com câncer de próstata metastático, sem tratamento prévio, submetidos à terapia de privação androgênica e tratamentos subsequentes. Eligard® 45 mg, em sua forma de depósito semestral, foi colocado em perspectiva econômica com outras seis apresentações de análogos de LHRH disponíveis no mercado nacional. Resultados: O bloqueio androgênico, com qualquer um dos análogos LHRH avaliados, resultou em uma expectativa de vida média de 31,44 meses em todas as perspectivas analisadas...

Inhibition of HepG2 cell growth by LHRH-MPG△NLS/CDK2-siRNA nanoparticles / 国际生物医学工程杂志

Objective To detect the size distribution and Zeta potential of LHRH-MPG△NLS/CDK-siRNA nanoparticles,to observe the effect of different solvents on the nanoparticle size,and to investigate the inhibitory effect of nanoparticles on HepG2 cell growth.Methods LHRH-MPG △NLS and CDK2-siRNA were mixed by continuous stirring to form nanoparticles at different N/P ratios (10/1,20/1 and 40/1).The size distribution and Zeta potential of LHRH-MPG△NLS/CDK2-siRNA nanoparticles were detected by dynamic light scattering,and the stability of the nanoparticles in normal saline,10％ glucose and pure water was discussed.Finally,the inhibitory effect of the nanoparticles on HepG2 cells was determined by CCK8 kit.Results The mean size of the nanoparticles was within 200 nm,and the Zeta potentials were (70±5) mV (N/P=10/1),(120±5) mV (N/P=20/1) and (130±5) mV (N/P=40/1),respectively.The size of the nanoparticles in normal saline was significantly increased,which demonstrated that strong electrolytes had a great impact on the nanoparticles size.When nanoparticle concentration was 200 nmol/L,LHRH-MPG△NLS/CDK2-siRNA nanoparticles (N/P=10/1) showed significantly inhibitory effect on HepG2 cell growth.Conclusions The mean size of the LHRH-MPG△NLS/CDK2-siRNA nanoparticles was within 200 nm,which was ideal for cellular uptake.The Zeta potential of nanoparticles revealed that nanoparticles could be stable in aqueous solution,while strong electrolytes would affect nanoparticle size.When nanoparticle concentration was 200 nmol/L,LHRH-MPG△NLS/CDK2-siRNA nanoparticles (N/P=10/1) showed significantly inhibitory effect on HepG2 cell growth.

Assessment of efifcacy of GnRH analogs by LHRH stimulation test in children with central precocious puberty / 临床儿科杂志

Objective To evaluate and monitor the efifcacy of GnRH analogs (GnRHa) therapy. Methods Thirty girls with central precocious puberty diagnosied by LHRH stimulation test were treated with GnRHa for 6-24 months. The LHRH stimula-tion test were performed again at 3 months after initiation of therapy and then every 6 months during treatment. The relationship of peark LH and clinical suppressing pubertal (including Turner stage, bone age, grwoth speed) were compared. The monitor effect of peak LH to efifcacy of GnRHa were eveluated. Results Ninety LHRH stimulation tests were performed, only 7 cases were found to have clinical pubertal development. After 6 months treatment, the base LH level of thirty girls (0.48±0.20) IU/L was signiifcantly lower than that before the treatment (0.75±0.35 IU/L) (P=0.000). The correlation coefifcient between base LH and peak LH was 0.62. The best correlation between clinical suppressing pubertal and LHRH stimulation test was achieved when peak LH was less than 2 IU/L (85.7%sensitivity, 100%speciifcity). Conclusions Base LH value can be used in preliminary as-sessment of the efifcacy of GnRHa therapy for girls with central precocious puberty. The peak LH less than 2 IU/L can be as the indicator of treatment efifcacy.

Tratamiento con dietilestilbestrol en pacientes refractarios a la castración por análogos LH- RH / Treatment with diethylstilbestrol in patients who had failed to androgen deprivation by lhrh agonists

Introducción: El objeto de este trabajo clínico es estudiar la eficacia de la administración de Dietilestilbestrol (DES) oral en pacientes con cáncer de próstata avanzado y que han presentado refractariedad al tratamiento con análogos LH-RH y además evaluar los efectos colaterales atribuibles a su uso. Material y métodos: Entre Noviembre de 2010 y Mayo de 2012 se ingresaron en forma consecutiva al estudio 15 pacientes con cáncer prostático avanzado, refractarios a manejo con análogos LH-RH. Edad promedio de los pacientes 69,4 años .Rango 57-80. Se registró el tipo de tratamiento realizado, detallando el manejo hormonal previo al que fueron sometidos. Se consideró refractariedad a los análogos, la detección de 2 alzas consecutivas del APE durante la administración de éstos. Se indicó a los pacientes 1mg. de DES al día. La evaluación del tratamiento se hizo cada 30 días con determinación de APE y registro de efectos colaterales. Resultados: De los 15 pacientes, 8 (53,3 por ciento) disminuyeron su APE inicial, 6 de ellos (40 por ciento) lo hicieron en más de un 50 por ciento de su valor y 2 (13,3 por ciento) disminuyeron el APE pero en menos de un 50 por ciento. 7 pacientes (46,6 por ciento) no disminuyeron su valor de APE y fueron considerados como fracasos. Como efectos colaterales del tratamiento tuvimos 13 pacientes (86,6 por ciento) que presentaron hipersensibilidad de los pezones, pero solo 2 requirieron tratamiento sintomático. 4 pacientes (26,6 por ciento) desarrollaron ginecomastia leve a moderada y no tuvimos ninguna complicación cardiovascular en los 15 pacientes estudiados. Conclusión: Consideramos de acuerdo a nuestros resultados que el DES oral es efectivo como tratamiento en los pacientes que han fallado o son refractarios a la deprivación androgénica por análogos LH-RH, con una baja morbilidad, buena aceptación de los pacientes y de muy bajo costo.

Introduction: The object of this clinical trial is to study the effectiveness of the administration of Diethylstilbestrol (DES) oral in patients with advanced cancer of prostate and that has presented resistance to the treatment with analogs LH-RH and in addition to evaluate the collateral effects attributable to its use. Material and methods: Between November of 2010 and May of 2012 15 patients with advanced prostate cancer, refractory to handling with analogs LH-RH entered themselves in consecutive form the study. Age average of the patients 69, 4 years, Rank 57-80. The type of made treatment was registered, detailing previous the hormonal handling which they were put under. Resistance to the analogs, the detection of 2 consecutive rises of the PSA was considered during the administration of this one. 1 mg. was indicated to the patients of DES to the day. The evaluation of the treatment was made every 30 days with determination of PSA and registry of collateral effects. Results: Of the 15 patients, 8 (53,3 percent) diminished their initial PSA, 5 of them (40 percent)did in more of a 50 percent of their value and 2 (13,3 percent) diminished the PSA but in less of a 50 percent. 7 patients (46,6 percent) did not diminished their value of PSA and were considered like failures. As collateral effects of the treatment we had 13 patients (86,6 percent) who presented hypersensitivity of the nipples, but single 2 required symptomatic treatment, 4 patients (26,6 percent) developed ginecomastia weighs moderate and we did not have any cardiovascular complication in the 15 studied patients. Conclusion: We considered according to our results that the oral DES is effective like treatment in the patients who have failed or ar refractory to the androgenic deprivation by analogs LH-RH, with a low morbidity, good acceptance of the patients and very low cost.

Conceptos actuaees sobre mecanismos reguladores de la pubertad / Current concepts regarding mechanisms regulating puberty

El inicio de la pubertad depende de la activación del eje hipotálamo-hipofisiario-gonadal. Existe una red glial y neuronal que interactúa por medio de moléculas de adhesión, factores de crecimiento, aminoácidos, péptidos y derivados lipídicos, que permiten integrar en el hipotálamo la información del estado metabólico del individuo con la que proviene del medio ambiente determinando el comienzo y mantenimiento de la etapa reproductiva. En los últimos años se ha ampliado la comprensión de los factores que intervienen en la pubertad, aunque no se han dilucido todos los mecanismos participantes. Este artículo revisa algunos de los procesos celulares y moleculares más importantes en la regulación de la secreción pulsátil de GnRH, con mayor énfasis en los conocimientos más recientes.

The onset of puberty depends on activating the hypothalamic-pituitary-gonadal axis. A glial and neuronal network interacts by means of adhesion molecules, growth factors, amino acids, peptides and lipid derivates, leading to information about an individual's metabolic state becoming integrated with that from the environment in the hypothalamus and thereby determining the start of the reproductive stage and its maintenance. Understanding about the factors intervening in puberty has become greater during the last few years, even though all the participating mechanisms have not yet been elucidated. This article reviews some of the most important cellular and molecular processes in regulating pulsatile gonadotropin-releasing hormone (GnRH) secretion, placing greater emphasis on the most recent knowledge.

Stabilization of luteinizing hormone-releasing hormone in a dry powder formulation and its bioactivity.

Background: Luteinizing hormone-releasing hormone (LHRH) is a naturally occurring hormone that controls sexhormones in both men and women. In general, LHRH is poorly absorbed through the gastrointestinal tract due to its large molecular size, high polarity, and loss from enzymatic degradation. Objective: Prepare and develop LHRH in a dry power formulation with stability and biological activity. Methods: Mannitol (M) and glycine (G) were chosen as ingredients to stabilize and protect LHRH during the freeze drying processes and during storage. The physicochemical properties of LHRH dry powders were examined by capillary electrophoresis, fluorescence spectrophotometry, scanning electron microscopy, and photon correlation spectroscopy. The release of LHRH from the dry powder was carried out in dissolution apparatus. In addition, a rat model was employed to study the bioactivity of LHRH in the dry powder form. Results: The LHRH dry powder formulations using M and G in the ratios of 6:4 and 7:3 were more stable than other formulations. LHRH colloids containing M:G showed no aggregation after storage at 4°C for one month. The concentration of LHRH in the dry powder form was more stable than that of LHRH in solution form. All the LHRH dry powder formulations were instantly dissolved within 10 seconds in an aqueous medium. After the LHRH dry powder (13 mg) was reconstituted and administered intraperitoneally to male rats during a one-month period, the testosterone level in the plasma was significantly decreased compared with an untreated group (15.0±1.0 ng/mL, 15.0±1.0 ng/mL and 20.0±2.0 ng/mL for LHRH containing M:G; 6:4, 7:3, and 8:2, respectively, compared to the control of 35±2 ng/mL, p<0.05). Conclusion: The LHRH dry powder formulations had good physicochemical properties and bioactivity.

Galanin regulation of LH release in male rats.

The present study examines the role of cerebroventricular administered (IIIrd ventricle) galanin on LHRH and LH release in adult and immature male rats. In both age groups, galanin stimulated LHRH synthesis and release from the hypothalamus, leading to a higher release of pituitary LH which in turn increased plasma LH levels. Galantide, a galanin receptor blocker, on the other hand, drastically reduced hypothalamic LHRH and plasma LH while increasing pituitary LH. In vitro incubation of anterior pituitary cells with galanin followed by LHRH resulted in increased release of pituitary LH but not by galanin alone. Galantide exhibited no such effect either alone or with LHRH. These results indicate that galanin is an important regulator for both hypothalamic LHRH and hypophysial LH and its role is independent of age in the case of male rats.

Successful treatment of unilateral cryptorchid boys risking infertility with LH-RH analogue

INTRODUCTION: Infertility is the primary concern for boys with uni- or bilateral undescended testes. An early and seemingly successful orchiopexy does not improve fertility in a substantial number of cryptorchid males. We confirmed that LH-RH analogue (LH-RHa) treatment induces an increase in and maturation of the germ cells; however, it was uncertain if treatment would improve the chance of fertility later in life. MATERIALS AND METHODS: Thirty unilateral cryptorchid boys, with an average age of 3 years at the time of surgery, were included in the study. Testicular biopsy showed that they had impaired testicular maturation and were therefore at high risk for infertility. Fifteen of the 30 unilateral cryptorchid boys were treated with 10 µg LH-RHa (Buserelin) nasal spray, administered on alternate days for a period of 6 months, following orchiopexy. The control group consisted of 15 cryptorchid boys who had been treated by Schoemakers type of orchiopexy, alone. After puberty, the ejaculates of both groups were analyzed. RESULTS: All males in the untreated group were severely oligospermic, with 20 percent being azoospermic. In contrast, 86 percent of the treated ex-cryptorchid males had a sperm concentration within the normal range; this was significantly different from the sperm concentration found in the untreated group (p = 0.000008). CONCLUSION: For the first time, we demonstrate that infertility in cryptorchidism can be successfully corrected when suitably treated with a LH-RHa. Sperm parameters normalized following therapy in the majority of cryptorchid males who, untreated, would have remained infertile. This innovative hormonal treatment will have a profound effect on the current recommended surgical treatment of boys with undescended testes.

Incidence Rate of Injection-Site Granulomas Resulting from the Administration of Luteinizing Hormone-Releasing Hormone Analogues for the Treatment of Prostatic Cancer

PURPOSE: Granulomas resulting from the administration of luteinizing hormone-releasing hormone analogues (LH-RH analogues) are thought to be very rare. We report on our clinical experience with injection-site granulomas that result from the administration of LH-RH analogues, and we evaluate the incidence rate of these granulomas. MATERIALS AND METHODS: We used the clinical records of 118 patients who were administered LH-RH analogues in 2005. We describe the clinical data of patients who experienced injection-site granulomas and evaluated the incidence rate. RESULTS: Five patients demonstrated injection-site granulomas due to LH-RH analogue administration. The incidence rate was 4.2% (5 of 118 patients). Most of the granulomas occurred after the first or second administration of 11.25mg of leuprorelin acetate. CONCLUSION: The occurrence of granulomas resulting from the administration of LH-RH analogues was thought to be very rare. Our study, however, revealed a higher incidence rate than expected, especially for leuprorelin acetate.

Influences of LHRH-PE40 on proliferation inhibition and apoptosis of human colon carcinoma cells / 吉林大学学报(医学版)

Objective To research the binding specificity of new recombination toxin LHRH-PE40 and LHRH receptor on the surface of human colon carcinoma cell line Lovo and the mechanism of anti-proliferation,and determine the apoptosis.Methods Lovo cells were analysed by LHRH-PE40 marked with()~(125)Ⅰ;the cytocidal effect of the anti-tumor was evaluated by MTT assay,and the apoptotic rate was analysed by flow cytometry.Results Lovo cells had the binding of aglucone and receptor.Half lethal dose of human colon carcinoma cells Lovo with LHRH-PE40 was 0.24 mg?L~(-1).The apoptotic rate was increased when the LHRH-PE40 concentration was ranged from 0.1 to 10 mg?L~(-1)(P

Construction and expression of recombinant cecropin B-binding site of luteinizing hormone releasing hormone gene and its anticancer function / 中华妇产科杂志

Objective To construct and express recombinant cecropin B-binding site of luteinizing hormone releasing hormone(CB-LHRH')gene,and to evaluate the anticancer function of CB-LHRH' on human ovarian cancer cell line SKOV3 and human endometrial cancer cell line HEC-1B.Methods The sequence of the cDNA encoding CB-LHRH' was designed,artificially synthesized,verified by DNA sequence analysis and expressed by Bac-to-Bac baculovirus expression system.The expression of CB-LHRH' proteins were identified by western dot blot using rabbit polyclonal antibody against LHRH as the primary antibody.To determine the anticancer effects of the CB-LHRH' protein,ovarian cancer cell line SKOV3 and endometrial adenocarcinoma cell line HEC-1B were treated by different doses of the CB-LHRH' protein.Cell growth inhibition assay was performed using the 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)5[(phenylamino) carbonyl]-2H-tetrazolium hydroxide(XTT)kit at different times,and cell morphologic changes were observed under the inverted microscope.Results The inhibitory rate of proliferation by CB-LHRH' increased with the increase of dose and time respectively:SKOV3 cell,from(5.03?0.08)% to(53.24 ?1.22)%;HEC-1B cell,from(5.13?0.37)% to(56.16?1.08)%.The inhibitory effect on HEC-1B cell was stronger than that on SKOV3 cell(P

Expressions of GnRH and GnRH receptor mRNA in female rats with danazol-induced precocious puberty / 中华内分泌代谢杂志

Objective To ob se rve the effects of danazol on hypothalamus-pituitary-gonad axises and expressi ons of hypothalamic GnRH and pituitary GnRH receptor mRNA in female rats. Methods Female rats at 5 days of age were given a sin gle subcutaneous injection of 300 ?g danazol to induce true precocious puberty. Animals were divided into 3 groups: normal control, model group and vehicle gro up. The day of vaginal opening from 25 days of age was monitored, and the establ ishment of first estrus cycle from the day of vaginal opening was investigated b y examination of vaginal smears. The weights of body, pituitary, adrenal, uterus and ovary were measured to identify the developmental status of main organs. Th e expressions of hypothalamic GnRH and pituitary GnRH receptor mRNA were assayed by semi-quantitative RT-PCR. Results Female rats treated with danazol significantly (P

The Patient`s Choice of Hormonal Treatment for Metastatic Prostate Cancer / 대한비뇨기과학회지

PURPOSES: We performed a study to estimate the attitude of patients toward orchiectomy, and the factors impacting to choose treatment in real situation. MATERIALS AND METHODS: One thousand one hundred and eighteen patients were asked questionnaires at their first visit of outpatient clinic. Among them 775 patients completed the questionnaires which are composed with three items asking the degree of acceptance for orchiectomy, the acceptable cost to save the testes. The responses were analysed according to ages, educational levels, occupations and final diagnosis. In 38 patients diagnosed with prostate cancer, we analysed the factors impacting on their decision when they faced to choose a method of antiandrogen therapy. RESULTS: Among 775 patients who make the definite decisions for orchiectomy, 212 patients(27.4%) accepted the orchiectomy, 452 patients(58.3%) denied orchiectomy, 111 patients(14.3%) want to avoid orchiectomy as much as possible. The younger patients are, the more they want to save their testes. The accepting orchiectomy of patient is not impacted by occupation or educational levels. Among 45 patients who were finally diagnosed as metastatic prostate cancer, 13 patients changed thier choices that they selected at first visit. The most common causes to choose orchiectomy was economic conditions and to choose LH-RH analogue was fear to surgery. CONCLUSIONS: Around three forth of men over 50 years old have negative attitude for orchiectomy. But this can be changed easily by the factors such as economic status, fear to surgery and doctor`s advise. If the higher the house income is, the more LH-RH analogue will be used.

Induction of ovarian follicular development in the subadult frog Rana tigrina using luteinizing hormone releasing hormone-acetate.

In the subadult Rana tigrina administration of 2 μg luteinizing hormone releasing hormone-acetate/frog six days a week for 4 weeks in April resulted in the formation of medium (in all 8 frogs) and large sized (in 4 out of 8 frogs) yolky oocytes and, concomitant increases in the oviductal mass. The ovarian and oviductal masses showed a 10-fold increase over the control frogs. In untreated frogs the ovaries were transparent and contained first growth phase oocytes only. The oviducts were also infantile. The pituitary sections were stained using antisera raised in rabbit against the β-subunit of human luteinizing hormone and human follicle stimulating hormone. Immunoreactivity, staining intensity, cytoplasmic granulation and, cell, nuclear and cytoplasmic areas of gonadotrophs (B2 cells) increased significantly in luteinizing hormone releasing hormone treated frogs. The above findings suggest that pituitary-ovarian axis in the subadult Rana tigrina is responsive to luteinizing hormone releasing hormone and that long-term treatment with the hormone induces cytomorphological changes in the gonadotrophs which result in the conversion of inactive cells into secretory cells. This is accompanied by precocious vitellogenic growth of oocytes in the subadult frogs.

LHRH-A for treating prostatic cancer with the occurrence of metastasis after castration (report of 9 cases) / 中华泌尿外科杂志

Objective To evaluate the use of LHRH A for treating prostatic cancer with the occurrence of metastasis or recurrence after castration. Methods LHRH A has been instituted to 9 cases of pathologically verified prostatic cancer with the occurrence of metastasis or recurrence after castration.The therapeutic results were studied. Results Ideal improvement was noted in 4 with all the parameters turned normal.These 4 patients have survived well for 7,3,2 and 1 year respectively.Marked improvement occurred in 2 with part of the parameters turned normal or markedly improved shortly after the treatment.The condition of 1 patient became stable with drop of blood PSA and shrinkage of the prostatic mass.In 3 patients,the metastatic lesion became stable.with the use of LHRH A,the penis became markedly atrophic. Conclusions LHRH A is markedly effective in most cases of prostatic cancer with the occurrence of metastasis or recurrence after castration.The therapeutic efficacy depends on the sensitivity of the prostate cancer cells to the drug.Drug resistance may issue as time goes by.

A case of idiopathic precocious puberty treated with a luteinizing hormone relaeasing hormone analog

No abstract available.

Intranasal LH-RH treatment of cryptorchidism / 대한비뇨기과학회지

The effect of intranasal luteinizing hormone-releasing hormone (LH-RH) on cryptorchidism was investigated in 15 prepubertal boys with 26 undescended testes. Eleven patients were bilateral cryptorchidism. Boys with retractile testes, ectopic testes or palpable hernia, as well as boys who had chromosomal abnormalities were excluded from admission to the study. Synthetic LH-RH (Cryptocurs) was applied as nasal spray at a dose of 1.2mg daily over a period of 4 weeks. Testicular position and mobility were assessed independently by two investigator before and after 4 and I6 weeks of therapy. Testicular descent into the scrotum occurred in 5(19%) and partial descent in 10 testes (38%). Descended testes were bilateral cryptorchidism and located below the inguinal area in all cases. Follow-up examination 4 months after therapy showed no relapse. No side effects were observed. Overviewing the literature and regarding our own results, we believe that LH-RH has a place in the treatment of cryptorchidism. In the treatment of the more caudally positioned and bilateral undescended testes, it can be beneficial, because of the potential merits of avoiding an operation and the small number of minor side effects.