Similar frequency of testosterone surge after repeat injections of goserelin (Zoladex) 3.6 mg and 10.8 mg: Results of a randomized open-label trial

Zinner, Norman R.; Bidair, Mohamed; Centeno, Arthur S.; Tomera, Kevin M.

doi:10.1016/j.urology.2004.07.033

Cited by 56 publications

(35 citation statements)

References 13 publications

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“…Thus, we should think the use of long term therapy to obtain the optimum results. Zinner et al [20] showed that in most (77.4%) patients receiving long-term therapy with 3.6 mg goserelin, the testosterone levels were consistently maintained within the castrate range. The present study demonstrated that one-dose administration of goserelin 3.6 mg depot is not effective in reducing blood loss and did not have suppressive effects on MVD in prostatic tissues.…”

Section: Discussionmentioning

confidence: 99%

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Kılıç¹

2014

Ann Clin Anal Med

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ÖzetAmaç: Prostat'ın transüretral rezeksiyonundan (TUR-P) önce uygulanan tek doz goserelin' in, benign prostat hiperplazisi (BPH) olan hastalarda kan kaybı ve prostat subüretral dokunun mikrovasküler dansitesi (MVD) üzerine olan etkilerinin belirlenmesi amaçlandı. Gereç ve Yöntem: TUR-P planlanan hastalar iki gruba randomize edilerek ayrıldı. Ameliyattan 1 ay önce 3,6 mg subkütan goserelin asetat uygulanan 18 hasta Grup 1'i oluşturdu. Grup 2 ise goserelin verilmeyen 21 hastadan oluşturuldu. İntraoperatif kanama miktarı ölçüldü.Her hasta için toplam kan kaybı, toplam kan kaybı/ ameliyat süresi, toplam kan kaybı/ rezeke edilen doku gramı hesaplandı. Prostat subüretral doku kesitleri mikrovasküler dansitesi açısından incelendi. Bulgular: Ameliyattan hemen sonra yapılan kontrolde; grup 1'deki hemoglobin (Hb) düşüşü grup 2'ye göre daha fazlaydı ve ortalama Hb seviyesi grup 1'de grup 2'ye kıyasla istatistiksel olarak anlamlı derecede düşük bulundu (p=0.028). İstatistiksel olarak anlamlı olmamasına rağmen irrigasyon sıvısında Hb konsantrasyonu ve ameliyat süresince kan kaybı grup 1'de grup 2'ye oranla daha yüksekti, buna karşılık TUR-P süresine göre ve rezeke edilen prostat doku ağırlığına göre kan kaybı ise grup 1'de grup 2'ye gore daha düşüktü. Mikrovasküler dansite grup 2'de belirgin olarak daha azdı. Tartışma: Bir aylık tek doz goserelin tedavisi, TUR-P boyunca olan kan kaybını azaltmada etkili değildir ve prostat dokusunda mikrovasküler dansitesi üzerinde süpresif etkisi yoktur. Anahtar KelimelerBenign Prostat Hiperplazisi; Goserelin; Mikrovasküler Dansite; Kan Kaybı; Prostatın Transüretral Rezeksiyonu Abstract Aim: To determine the effects of one dose goserelin before transurethral resection of the prostate (TUR-P) on blood loss and microvessel density (MVD) of prostatic suburethral tissues in the patients with benign prostatic hyperplasia (BPH). Material and Method: The patients who planned to have a TUR-P were randomly divided into two groups. Group-1 consisted of 18 patients who were pretreated with 3,6 mgr subcutaneous injection of goserelin acetate one month before the operation. Group-2 was constructed from 21 patients without goserelin acetate pretreatment. The amount of intraoperative haemorrhage was calculated. Total blood loss, total blood loss/duration of surgery and total blood loss/gram of resected tissue were calculated for each patient. Sections from the prostatic suburethral tissues were examined for microvessel density. Results: Quantitative decreases in Hb were greater in group 1 than in group 2, and mean Hb level was statistically significantly lower in group 1 than in group 2 at the control just after the operation (p=0.028). Although all the differences were statistically insignificant, Hb concentration in irrigation fluid and total blood loss during surgery were higher in the group 1 than in the group 2, contrarily, blood loss by duration of TURP and blood loss by weight of resected prostate tissue were less in the group 1 than in the group 2. The MVD was significantly lower in group 2 than ...

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Section: Discussionmentioning

confidence: 99%

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Kılıç¹

2014

Ann Clin Anal Med

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“…The National Comprehensive Cancer Network has agreed that levels ≤20 ng/dL were desirable, 21 but in the most recent version the Network simply recommend maintaining "castrate serum levels of testosterone." 22 These views do not address additional drawbacks associated with all of the LHRH agonists: the initial surge (clinical flare) 23 and the intermittent mini-surges occurring during treatment after a T nadir has been reached 24 -both believed to affect survival. 25 More recently, a large study by Pickles and colleagues 26 confirmed the occurrence of T breakthroughs during LHRH therapy and documented that once they happen, there is an increased tendency for their recurrence.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of suboptimal hormonal levels in men with prostate cancer treated with LHRH agonists

Kawakami

Morales

2013

CUAJ

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E226 research researchCite as: Can Urol Assoc J 2013;7:E226-30. http://dx.doi.org/10.5489/cuaj.540 AbstractPurpose: We examined the serum levels of testosterone (T) (total and bioavailable) dehydroepiandrosterone (DHEA), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prostatespecific antigen (PSA) in men receiving treatment with luteinizing hormone releasing-hormone (LHRH) agonists for metastatic prostate cancer. In doing this, we want to determine the efficacy of these agents in lowering T levels and whether a possible relationship exists between PSA values, as a surrogate measure of tumour activity, and hormone levels. Methods: This was a single centre prospective study of patients on LHRH agonists. Of all the 100 eligible patients, 31 did not qualify (10 were receiving their first injection, 13 were on intermittent hormonal therapy, 7 refused to enter the trial and 1 patient's blood sample was lost). Therefore in total, 69 patients were included in the final analysis. Each patient had their blood sample drawn immediately before the administration of a LHRH agonist. The new proposed criteria of <20 ng/dL (0.69 nmol/L) of total testosterone was used to define optimal levels of the hormone in this population.

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“…However, potentially important data have emerged recently that indicate that testicular androgen suppression with LHRHa may not be complete, in that 'breakthroughs' (in which testosterone levels peak above the lower limit of the castrate range) and 'miniflares' or microsurges (in which the initial testosterone flare after the first LHRHa injection is replicated at lower levels on subsequent injections) may both occur. 10,11 The clinical significance of these phenomena is, as yet, unknown, but in light of the new biological insights afforded by the abiraterone acetate story, they merit further investigation. Reassuringly, data so far on intermittent androgen deprivation suggest that testosterone fluctuations in that context may not be adverse, although further data are needed from ongoing randomised trials, and the effects of androgen fluctuations at low levels could conceivably differ from those at higher levels.…”

Section: Lhrh Antagonistsmentioning

confidence: 99%

Management of prostate cancer: future treatment approaches

Mason

2009

Future Prescriber

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Prostate cancer is now the most commonly diagnosed cancer in men. This may reflect a true increase in the incidence of the disease, but a component of it is certainly related to increased detection rates due to opportunistic prostate specific antigen (PSA) testing. In this article, Professor Malcolm Mason reviews the current treatment of prostate cancer and considers promising future treatment options, including the possibility of prevention as suggested by recent studies.

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Similar frequency of testosterone surge after repeat injections of goserelin (Zoladex) 3.6 mg and 10.8 mg: Results of a randomized open-label trial

Cited by 56 publications

References 13 publications

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Effects of Goserelin Treatment on Microvessel Density and Blood Loss Associated with Transurethral Resection of the Prostat

Clinical significance of suboptimal hormonal levels in men with prostate cancer treated with LHRH agonists

Management of prostate cancer: future treatment approaches

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