PURPOSE: The purpose of this study was to evaluate cycling change and characteristics of treatment in patients receiving intermittent androgen suppression (IAS). MATERIALS AND METHODS: From May 1995 to April 2001, we retrospectively reviewed 28 cases of prostate cancer patients treated with IAS. Treatment was initiated with goserelin acetate with flutamide and continued until serum PSA nadir was observed. Medication was then withheld till the serum PSA increased to a predetermined level. This cycle of treatment and no-treatment was repeated until the regulation of PSA became androgen independent. RESULTS: Patients have completed at least one, and up to four treatment cycles. Mean nadir serum PSA level was 0.69ng/ml, 0.70ng/ml, 1.15ng/ml, 2.64ng/ml for each cycle, and was reached within average 4.7 (2-8) months after beginning treatment. Patients spent an average of 42% of the time not receiving therapy, but the time off therapy decreased as the number of treatment cycles increased. In most cases, side effects related with androgen suppression was improved during off-treatment. CONCLUSIONS: IAS appears to be a possible treatment option in patients with prostate cancer. This approach could result in reduced toxicity and cost of treatment and affords an improved quality of life when the patient is off therapy.
Flutamide ; Goserelin ; Humans ; Prostate* ; Prostatic Neoplasms* ; Quality of Life ; Retrospective Studies

Paraphilia was a very treatment resistant psychiatric disorder. But new treatment strategies to paraphilia have been introduced recently. We report and review the effect of depot analogue (goserelin) administration in a 18 year-old adolescent with paraphilia. We administered goserelin 3.6 mg/month to him for 3 months, there were changes of scores in Clinical Global Improvement, Sex Addiction Screening Test, Freund Paraphilia Scales.
Adolescent ; Gonadotropin-Releasing Hormone ; Goserelin ; Humans ; Mass Screening ; Paraphilic Disorders ; Weights and Measures

PURPOSE: The purpose of this study was to evaluate the feasibility of using intermittent androgen deprivation(IAD) in patients with prostate cancer. MATERIALS AND METHODS: We reviewed the medical records of 29 patients treated with IAD for prostate cancer. Androgen deprivation with goserelin and flutamide was continued for at least 4 months after serum prostate specific antigen(PSA) became undetectable or a nadir level was reached. Medication was then discontinued until serum PSA reached a predetermined level. This cycle of treatment was repeated until there was evidence of androgen independence. RESULTS: Twenty-one patients completed the on-treatment during cycle 1, with a median time to PSA nadir of 3 months. Nine patients completed cycle 1 with a median time of off-treatment of 11 months(38% of a treatment cycle). Eight patients continued the off-treatment during cycle 1 for 1+ to 8+ months. During cycle 2, 3 patients achieved a PSA nadir in a median time of 3.5 months. While off treatment, most patients reported reduction of symptoms associated with androgen suppression. CONCLUSIONS: IAD is a feasible alternative for continuous androgen deprivation for treatment of prostate cancer. It also results in the reducion of toxicity, cost of treatment, and possibly a delay in tumor progression.
Flutamide* ; Goserelin* ; Humans ; Medical Records ; Pilot Projects* ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms*

PURPOSE: We aimed to evaluate the therapeutic effect of maximal androgen blockade (MAB) compared with that of medical or surgical castration alone in the treatment of the metastatic prostate cancer. MATERIALS AND METHODS: We reviewed the progressive status and the survival of the patients with stage D Prostate cancer who had received hormonal therapies at our institution. Classified by treatment arms, the patients were divided into two groups. Group I was composed of 82 patients who had undergone either bilateral orchiectomy or GnRH agonist (goserelin acetate) injection alone, and Group II, of 65 patients who had undergone MAB with antiandrogen (flutamide) in addition to bilateral orchiectomy or gosereline acetate injection. We investigated the overall survival, time to objective progression, progression-free survival, and side effects. RESULTS: The 5 year survival rates of Group I and II were 31.2 % and 32.5%, respec tively and median survival after the treatment was 34.2 months and 38.0 months respectively, which showed no significant differences between the two groups (p=0.21). The time to objective progression was 22.0 months in Group I and 24.0 months in Group II (p=0.52). Furthermore, each of median progression-free survival was 23.0 months and 24.0 months, respectively (p=0.79). In the minimal disease group, MAB appeared to increase the overall survival rate by 9.7%, progression-free survival rate by 7.3% and the time to objective progression by 10 months, respectively compared with the monotherapy. CONCLUSIONS: In the hormonal therapy for the patients with stage D prostate cancer, there were no significant differences in overall survival, median progression-free sur vival, and time to objective progression between monotherapy and MAB. This indicates that MAB does not have any advantages.
Arm ; Castration ; Disease-Free Survival ; Gonadotropin-Releasing Hormone ; Goserelin ; Humans ; Orchiectomy ; Prostate* ; Prostatic Neoplasms* ; Survival Rate

Desmoid tumor is a subtype of fibromatosis arising from deep fascial or soft tissue structure. It is characterized by locally aggressive behavior with a tendency to local recurrence, but is generally accepted the lack of ability for distant metastasis. Although excision is the best initial therapy, surgery is not always amenable in cases of lesions lying in difficult anatomical area. Two female patients with recurrent desmoid tumor in abdomen and pelvis after excision were treated with tamoxifen, goserelin, and sulindac. This therapy led to a progressive decrease of tumor size within 13 months in one patient. However, in the other patient, this combined therapy failed to reduce the size of the tumor. Despite the success of combined therapy with hormone and nonsteroidal anti-inflammatory drug is anecdotal, this treatment may improve the survival and reduce the recurrence in certain sub-group of desmoid tumor.
Abdomen* ; Deception ; Female ; Fibroma ; Fibromatosis, Aggressive* ; Goserelin* ; Humans ; Neoplasm Metastasis ; Pelvis ; Recurrence ; Sulindac* ; Tamoxifen*

Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent episodes of incapacitating nausea and vomiting interspersed with symptom free periods. Common triggers of cyclic vomiting include noxious stress, excitement, fatigue and menstrual period. Here, we report a case of cyclic vomiting syndrome in adult patient characterized by stereotypical vomiting attack, occurring in every menstruation period. Recurrent vomiting episodes began 6 years ago and we treated this patient with subcutaneous injection of goserelin, a gonadotropin-releasing hormone analogue (GnRHa) and oral estrogen. After 4 months of therapy, she was symptom free for the following 5 years, even with the resumed normal menstruation. Recurrence of vom - iting attack with same pattern occurred 1 month before readmission. Treatment with intravenous lorazepam aborted vomiting, but could not prevent recurrences of vomiting and epigastric pain. We treated the patient with GnRHa and oral estradiol again which effectively prevented recurrence of the symptoms.
Adult ; Estradiol ; Estrogens ; Fatigue ; Female ; Gonadotropin-Releasing Hormone ; Goserelin ; Humans ; Injections, Subcutaneous ; Lorazepam ; Menstruation ; Nausea ; Recurrence ; Vomiting

OBJECTIVE: To investigate the basal bone mineral density(BMD)s of the lumbar spine and femur of patients with endometriosis, and the changes of BMDs and biochemical bone markers after 6 months of gonadotropin releasing hormone(GnRH) agonist treatment. METHODS: The initial BMDs of 35 women with endometriosis were measured by dual energy x-ray absorptiometry at department of obstetrics & gynecology Yongsan Hospital, College of Medicine, Chung Ang University from April 1996 to May 1999. 19 patients of these group was repeatedly measured after 3.6mg subcutaneous depot injection of goserelin(Zoladex) every 4 weeks for 24 weeks. Osteocalcin and Deoxypyridinoline were measured before goserelin treatment, at 3 months, and at 6 months completion of goserelin treatment. RESULTS: Patients with endometriosis did not show the significant difference in mean BMD of lumbar spine and femur in comparison with age matched normal women. Patients treated with goserelin for 6 months showed 0.064+/-0.030g/cm2(5.56%) decrease of BMD in lumbar spine, 0.038+/-0.040g/cm2(3.85%) decrease in femur neck, 0.055+/-0.047g/cm2(6.10%) decrease in Ward triangle, 0.041+/-0.031g/cm2(5.19%) decrease in femoral trochanter. These data had statistical significance(p<0.001). At first 3 months and on completion of 6 months goserelin treatment, there were increase of 66.1%, 122.3% in serum osteocalcin respectively, and increase of 35.2%, 39.6% in urine deoxypyridinoline respectively, compared with pretreatment value. CONCLUSION: From these results, it is concluded that the BMDs of patients with endometriosis were normal, and after 6 months GnRH agonist treatment, bone loss was 3.85%-6.10%, and the values of biochemical bone markers were increased.
Absorptiometry, Photon ; Bone Density* ; Endometriosis* ; Female ; Femur ; Femur Neck ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Goserelin ; Gynecology ; Humans ; Obstetrics ; Osteocalcin ; Spine

OBJECTIVE: To define the pathologic changes underlying the mechanism of shrinkage of uterine leimyoma in patients treated with goserelin. METHODS: Retrospective evaluation of pathologic changes seen in leiomyoma removed by hysterectomy or myomectomy in treated and untreated patients was done. Microscopic review of all cases was performed without knowledge of the therapeutic history. Each leiomyoma was assessed for hyalinization, hydropic change, lymphocytic infiltrate, nuclear atypia, and hypercellularity. RESULTS: Hyaline degeneration and hydropic changes were found significantly more frequent in patient treated with goserelin (P<0.05). The differences between treated and untreated groups in lymphocytic infiltrate, nuclear atypia, and hypercellularity were not statistically significant. The ultrastructural features of variable numbers of the treated muscle cells showed large vacuole, marked swelling of mitochondria, and compound lysosomal structures presumed to have been formed from damaged intracellular organelles. CONCLUSION: It appears that the rapid decrease in size of the leiomyoma treated with goserein occurs as the smooth muscle tissue undergoes hydropic change and hyaline degeneration. It seems that other cellular degenerative changes may be involved in the mechanism shrinkage of uterine leiomyoma.
Gonadotropin-Releasing Hormone* ; Goserelin* ; Humans ; Hyalin ; Hysterectomy ; Leiomyoma* ; Mitochondria ; Muscle Cells ; Muscle, Smooth ; Organelles ; Retrospective Studies ; Vacuoles

PURPOSE: Endocrine therapy is the preferred treatment for hormone receptor (HR)-positive metastatic breast cancer (MBC). We investigated the efficacy of combined aromatase inhibitor (AI) and luteinizing hormone-releasing hormone (LHRH) agonist in premenopausal patients with HR-positive MBC. METHODS: We retrospectively analyzed the medical records of 21 HR-positive premenopausal MBC patients treated with combined AI and LHRH agonist therapy. RESULTS: The median follow-up period was 32.9 months. The overall response rate was 47.6%, with three complete responses (14.3%) and seven partial responses (33.3%). Nine patients (42.9%) achieved stable disease lasting more than 6 months; thus, the clinical benefit rate was 90.4%. The median time to progression was 45.4 months. No patients experienced grade 3 or 4 toxicity. CONCLUSION: Combined AI and LHRH agonist treatment safely and effectively induced remission or prolonged disease stabilization, suggesting that this could be a promising treatment option for HR-positive premenopausal patients with MBC.
Aromatase Inhibitors ; Aromatase* ; Breast Neoplasms* ; Breast* ; Follow-Up Studies ; Gonadotropin-Releasing Hormone* ; Goserelin ; Humans ; Lutein* ; Medical Records ; Premenopause ; Retrospective Studies

OBJECTIVE: To observe the dynamic change of anti-Müllerian hormone (AMH) in 1 year after chemotherapy which is the best biochemical marker of ovarian reserve in reproductive medicine setting and to evaluate the effect of gonadotropin-releasing hormone agonist (GnRHa)goserelin to prevent ovarian reserve function during (neo)adjuvant chemotherapy for young breast cancer patients. METHODS: Between December 2015 and June 2017, 101 breast cancer patients of age ≤ 45 years with stages I to III had been enrolled. The patients were assigned without interference to receive either (neo) adjuvant chemotherapy with goserelin (goserelin group) or without goserelin (chemotherapy group) as their own selection. AMH and menstrual status were evaluated before, during and 0.5 year, 1 year after chemotherapy. Primary end point was the incidence of low AMH value (<0.4 μg/L) at the end of 1 year. Secondary end point was the incidence of amenorrhea (the absence of menses in the preceding 12 months after assignment). RESULTS: In the study, 51 patients chose to join the chemotherapy group, while the other 50 patients selected goserelin to preserve their ovarian reserve function. More unmarried or childless, hormone receptors negative,receiving breast conservation therapy patients with earlier stage selected goserelin before chemotherapy. The incidence of low AMH value was significantly higher in chemotherapy group than in goserelin group (74.5% vs. 38.0%, P<0.001) in 1 year after chemotherapy. The incidence of amenorrhea was consistent with AMH (56.9% vs. 24.0%, P=0.001). And more patients' menstruation (78.9% vs. 54.5%) and AMH value (71.0% vs. 53.8%) recovered in goserelin group within 6 months after chemotherapy. In subgroup analysis, AMH and menstruation seemingly recovered more in goserelin group independent of age, chemotherapy regimen and use of tamoxifen. Especially, AMH value of 36.4% (8/22) patients in chemotherapy group and 18.4% (7/38) patients in goserelin group still maintained low level (<0.4 μg /L) although their menstruation had recovered 1 year after chemotherapy. In addition, 41 patients (20 patients in chemotherapy group, 21 patients in goserelin group) could be evaluated for the dynamic change of AMH and menstrual status during chemotherapy. The mean level of AMH in chemotherapy group declined rapidly to very low level before the 3rd cycle, while 70% of the patients kept presence of menstruation. At the same time, the mean level of AMH in goserelin group was still above 0.4 μg /L, but all of the patients had menopause. CONCLUSION Our study has offered evidence that Goserelin with chemotherapy could protect against ovarian reserve failure for young breast cancer patients, now that more patients' AMH value recovered earlier who had selected co-treatment. AMH may be a more precise marker than menstrual status to clinically evaluate ovarian reserve function pre-, during and post- chemotherapy.
Anti-Mullerian Hormone ; Biomarkers ; Breast Neoplasms/drug therapy* ; Chemotherapy, Adjuvant ; Female ; Goserelin/adverse effects* ; Humans ; Ovarian Reserve ; Ovary