Resumen

Objetives: To assess the clinical response to luteinizing hormone-releasing hormone (LH-RH) antagonist cetrorelix (SB-75) in patient with advanced carcinoma of the prostate and paraplegia dua to metastatic invesion of spinal cord. Methods: Cetrorelix was given at two different dose regimens to 5 patients with prostatic cancer Stage D2 and paraplegia. Urologic and neurologic examinations, laboratory studies, radiography (myelography), and prostate ultrasonography were carried out Prostate-specific antigen (PSA) and free testosterone were aslo measured. Results: In all patients, the neurologic symptoms regressed. The recovery of the thermic and vibratory sensation and motility of the toes was observed. The neurologic improvement continued during the treatment and at 3 months all the patients were able to walk with the aid of a cane. In 1 patient, the myelography showed that thas spinal cord compression had disappeared and prostate volume assessed by ultrasonography showed a singnificant decrease. The bladder function greatly improved in all 5 patients during the treatment with cetrorelix. Baseline levels of luteinizing hormone fell form 9.28 to 1.0 IU/L and those of follicle-Stimulating hormone (FSH) fell from 18.28 to 12 IU/L (P<0.05) after the first day of therapy with cetrorelix. Mean levels of free testosterone were reduced from 52.4 to 14.7 pmol/L (P<0.005) at 12 hours and to 13.1 pmol/L (P<0.005) 3 days after the first injection of cetrorelix. A persistent inhibition of gonadotropins and testosterone was maintained during tha subsequent 3 months of therapy. The high levels of PSA gradually decreased. Conclusions: Our results show that LH-RH antagonist cetrorelix causes an immediate lowering of the serum testosterone levels in patients with prostate cancer and metastases in the spinal cord, in whom the LH-RH agonists cannot be used as single drugs because of the possibility of flere-up and appears to be appropiate for long-term therapy.

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2004-05-11   |   651 visitas   |   Evalua este artículo 0 valoraciones

Vol. 5 Núm.2. Abril-Junio 1997 Pags. 37-43. Rev Endocrinol Nutr 1997; 5(2)