少量女性ホルモン(ジエチルスチルベストロール,2燐酸)による前立腺癌治療時の内分泌環境--単独およびアンチアンドロゲン(酢酸クロルマジン)との併用において--

Abstract

前立腺癌患者21例にDESP 50 mgとCMA 100 mgを併用経口投与し, 9例にDESP単独投与した.両群とも当初の1～3ヵ月間はテストステロン, FSH値は著明に減少し, LHは不十分ながら抑制されていた.併用群では1年間同じ値を維持していたが, 単独群では6ヵ月後にテストステロンは1.0±0.5 ng/mlまで増加した.PRLは両群とも増加した.心血管系障害を併用群で6例に(内2例が死亡), 単独群で2例に認めた.又併用群2例において, 乳汁分泌を伴う女性化乳房をみた

The testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin levels were measured by radioimmunoassay up to one year in 21 patients with prostatic carcinoma treated with diethylstilbestrol diphosphate (DESP), 50 mg/day, and chlormadinone acetate (CMA), 100 mg/day. The purpose of this treatment was to reduce the cardiovascular side effects which were believed to occur dose-dependently and to achieve the direct drug action to the prostate gland. The same measurements were made on 9 patients treated with DESP, 50 mg/day, alone. Marked reduction of plasma testosterone and FSH levels with weaker LH suppressions was observed during the first 1-3 months in both groups. The same levels were maintained up to the end of follow-up in DESP and CMA treatment group. In the DESP treatment group, the plasma level of testosterone showed a gradual increase to 1.0 +/- 0.5 ng/ml at the sixth month. Prolactin level increased gradually in both groups. Cardiovascular side-effects were found in 29% of the patients treated with DESP and CMA and in 22% of those treated with DESP alone. In two patients in the former group gynecomastia with lactation was observed.