Experience with a depot GnRH-agonist (Zoladex) in the treatment of genital endometriosis.

Eighty patients with different stages of genital endometriosis were treated with Zoladex, a gonadotrophin-releasing hormone analogue in a depot formulation, injected subcutaneously every 4 weeks. The stages of endometriosis (I-IV) were classified according to the revised American Fertility Society recommendations (AFS criteria) via pelviscopy before and after 6 months of treatment. Fifty-eight second-look pelviscopies were performed with the following objective changes after (before) treatment: Stage IV 0 (3); Stage III, 2 (13); Stage II, 12 (30); Stage I, 19 (12). Twenty-five patients presented with Stage 0 after therapy and were healed. All 57 symptomatic patients showed a subjective response to Zoladex therapy with a significant decrease of the total pelvic symptom score. Thirty-eight patients with infertility wished to become pregnant and so far 16 (40%) have conceived. During therapy, the serum concentrations of luteinizing hormone, follicle stimulating hormone, estradiol and progesterone were significantly suppressed. All patients were amenorrhoeic after 1-2 injections. Restoration of ovarian function with resumption of menstruation occurred within 57-92 days after the last injection of Zoladex (1-2 months after end of treatment). Side-effects were minimal and were those expected of the hypo-oestrogenic state, such as hot flushes, vaginal dryness and decrease of libido.

The depot GnRH analogue goserelin in the treatment of premenopausal patients with metastatic breast cancer--a 5-year experience and further endocrine therapies. Cooperative German Zoladex Study Group.

Continuous administration of gonadotrophin-releasing hormone (GnRH-)analogues leads to a receptor-down regulation of pituitary GnRH-receptors and subsequently inhibits ovarian hormone production. Since October, 1984, 118 evaluable pre- and perimenopausal patients (median age 42, range 25-55 years) with metastatic breast cancer were entered into an open phase II multicenter trial to evaluate efficacy of this new treatment modality. Patients were treated with the GnRH-analogue Goserelin (3.6 mg depot s.c. every 4 weeks) as first line therapy and followed up until progression. Mean serum gonadotrophins LH and FSH were significantly suppressed by Goserelin. Within 2-3 weeks, mean serum E2 values decreased to values seen in castrated women (less than 30 pg/ml). Overall objective response with complete and partial remissions (CR + PR) was achieved in 44.9% of patients with a median time to progression (mTTP) of 59 weeks, (range 20-163 weeks), no change (NC) in 28.0% with a mTPP of 27 weeks (range 16-101 weeks), and progression (P) in 27.1%. Responses were seen in ER-positive as well as ER-negative tumors, and in patients with different sites of metastases (locoregional, bone, visceral, multiple). The value of different prognostic factors in relation to response rates, time to progression and time to death (overall survival) is discussed. Median overall survival (time from beginning of palliative Goserelin treatment to death) was 148 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

[Necessities and possibilities for the prevention of cardiovascular and pulmonary diseases in childhood and adolescence]. / Notwendigkeiten und Möglichkeiten der Prävention kardiovaskulärer und pulmonaler Krankheiten im Kindes- und Jugendalter.

In an exploratory study involving 818 pupils 12-16 years of age blood pressure, total serum cholesterol, and smoking behavior were studied. 38.3% of the boys (N = 154) and 47.3% of the girls (N = 143) aged 15-16 demonstrated singular or combined elevated risk variables, cigarette smoking being the most predominant risk factor. 44.5% of the pupils of this age group answered to be regular smokers. 59.8% (N = 183) of secondary school pupils stated to be regular smokers as compared to 15.7% (N = 166) of grammar school pupils. The most important socialpsychological process variables were attitude of friends towards smoking, smoking experience of friends, and social function of smoking within groups. The importance of these variables showed differences according to type of school as well as gender which should be taken into account modelling preventing programmes.