BACKGROUND Leiomyomatosis peritonealis disseminata(LPD)is a rare condition characterized by multiple pelvic and abdominal nodules,which are composed of smoothmuscle cells.To date,no more than 200 cases have been repor...BACKGROUND Leiomyomatosis peritonealis disseminata(LPD)is a rare condition characterized by multiple pelvic and abdominal nodules,which are composed of smoothmuscle cells.To date,no more than 200 cases have been reported.The diagnosis of LPD is difficult and there are no guidelines on the treatment of LPD.Currently,surgical excision is the mainstay.However,hormone blockade therapy can be an alternative choice.CASE SUMMARY A 33-year-old female patient with abdominal discomfort and palpable abdominal masses was admitted to our hospital.She had undergone four surgeries related to uterine leiomyoma in the past 8 years.Computed tomography revealed multiple nodules scattered within the abdominal wall and peritoneal cavity.Her symptoms and the result of the core-needle biopsy were consistent with LPD.The patient refused surgery and was then treated with tamoxifen,ulipristal acetate(a selective progesterone receptor modulator),and goserelin acetate(a gonadotropin-releasing hormone agonist).Both tamoxifen and ulipristal acetate were not effective in controlling the disease progression.However,the patient achieved an excellent response when goserelin acetate was attempted with relieved syndromes and obvious shrinkage of nodules.The largest nodule showed a 25%decrease in the sum of the longest diameters from pretreatment to posttreatment.Up to now,2 years have elapsed and the patient remains asymptomatic and there is no development of further nodules.CONCLUSION Goserelin acetate is effective for the management of LPD.The long-term use of goserelin acetate is thought to be safe and effective.Hormone blockade therapy can replace repeated surgical excision in recurrent patients.展开更多
Objective:Real-word data on long-acting luteinizing hormone-releasing hormone(LHRH)agonists in Chinese patients with prostate cancer are limited.This study aimed to determine the real-world effectiveness and safety of...Objective:Real-word data on long-acting luteinizing hormone-releasing hormone(LHRH)agonists in Chinese patients with prostate cancer are limited.This study aimed to determine the real-world effectiveness and safety of the LHRH agonist,goserelin,particularly the long-acting 10.8-mg depot formulation,and the follow-up patterns among Chinese prostate cancer patients.Methods:This was a multicenter,prospective,observational study in hormone treatment-na?ve patients with localized or locally advanced prostate cancer who were prescribed goserelin 10.8-mg depot every 12 weeks or 3.6-mg depot every 4 weeks with or without an anti-androgen.The patients had follow-up evaluations for 26 weeks.The primary outcome was the effectiveness of goserelin in reducing serum testosterone and prostate-specific antigen(PSA)levels.The secondary outcomes included testosterone and PSA levels,attainment of chemical castration(serum testosterone<50 ng/d L),and goserelin safety.The exploratory outcome was the monitoring pattern for serum testosterone and PSA.All analyses were descriptive.Results:Between September 2017 and December 2019,a total of 294 eligible patients received≥1 dose of goserelin;287 patients(97.6%)were treated with goserelin 10.8-mg depot.At week 24±2,the changes from baseline[standard deviation(95%confidence interval)]in serum testosterone(n=99)and PSA(n=131)were-401.0 ng/d L[308.4 ng/d L(-462.5,-339.5 ng/d L)]and-35.4 ng/m L[104.4 ng/m L(-53.5,-17.4 ng/m L)],respectively.Of 112 evaluable patients,100(90.2%)achieved a serum testosterone level<50 ng/d L.Treatment-emergent adverse events(TEAEs)and severe TEAEs occurred in 37.1%and 10.2%of patients,respectively.The mean testing frequency(standard deviation)was 1.6(1.5)for testosterone and 2.2(1.6)for PSA.Conclusions:Goserelin 10.8-mg depot effectively achieved and maintained castration and was well-tolerated in Chinese patients with localized and locally advanced prostate cancer.展开更多
Background:Few studies compared the effectiveness of the 3-monthly goserelin 10.8-mg and the monthly 3.6-mg depot in inducing ovarian function suppression for premenopausal patients with hormone receptor positive(HR+)...Background:Few studies compared the effectiveness of the 3-monthly goserelin 10.8-mg and the monthly 3.6-mg depot in inducing ovarian function suppression for premenopausal patients with hormone receptor positive(HR+)breast cancer.We conducted a large-scale real-world study(RWS)in China to validate the non-inferiority of goserelin 10.8-mg to the 3.6-mg depot.Methods:This multicenter,retrospective-prospective,non-inferiority study compared goserelin 10.8-mg with 3.6-mg in suppressing estradiol(E2)levels in premenopausal and perimenopausal patients with HR+breast cancer.Eligible patients were identified,and their demographic and clinical data were obtained from hospital medical records.The observation period was 28 weeks.Propensity score matching(PSM)ensured baseline comparability.The primary endpoint was the proportion of patients with E2 suppression to postmenopausal level at Week 12±4.Difference in proportions and 95%CI was calculated by Newcombe-Wilson score method.The non-inferiority margin was-10%.Subgroup and sensitivity analyses assessed result robustness.Results:From 1st January,2015 to 15th December,2023,15,629 patients from 16 hospitals nationwide were screened,with 1,060 eligible patients included in the full analysis set(3.6-mg group:678;10.8-mg group:382).Post-PSM,the primary endpoint was analyzed in 590 patients(295 in each group).At Week 12±4,the proportion of patients with E2 suppression was 99.1%(95%CI:96.9%-99.8%)for goserelin 10.8-mg and 95.3%(95%CI:91.0%-97.6%)for goserelin 3.6-mg.The difference was 3.8%(95%CI:0.6%-8.1%)with the lower limit of 95%CI greater than the non-inferiority margin.All subgroup analyses,including those based on age(≤45 or>45 years)and previous chemotherapy(yes/no),and all sensitivity analyses on the primary endpoint were consistent with the main analysis.展开更多
目的:基于Meta分析方法,系统评价戈舍瑞林联合比卡鲁胺用于前列腺癌术后的疗效及安全性,为临床治疗前列腺癌患者提供循证依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Embase、PubMed、Web of Science和t...目的:基于Meta分析方法,系统评价戈舍瑞林联合比卡鲁胺用于前列腺癌术后的疗效及安全性,为临床治疗前列腺癌患者提供循证依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Embase、PubMed、Web of Science和the Cochrane Library等数据库,纳入戈舍瑞林联合比卡鲁胺用于前列腺癌术后的随机对照试验(联合治疗组采用戈舍瑞林联合比卡鲁胺治疗,对照组单纯使用比卡鲁胺治疗)。文献检索时间为建库初始至2024年10月,采用RevMan 5.4.1软件进行Meta分析,结局指标包括临床治疗总有效率,血清前列腺特异性抗原(PSA)、游离前列腺特异性抗原(f-PSA)、血管内皮生长因子(VEGF)和α-甲酰基辅助A消旋酶(P504S)水平,以及不良反应发生率。结果:检索得到8篇随机对照试验文献,共纳入患者602例(联合治疗组301例,对照组301例)。Meta分析结果显示,与单纯使用比卡鲁胺比较,戈舍瑞林联合比卡鲁胺治疗能够提高临床总有效率(OR=3.85,95%CI=2.43~6.10,P<0.00001),显著降低血清PSA水平(MD=-6.74,95%CI=-9.99~-3.49,P<0.0001)、f-PSA水平(MD=-1.27,95%CI=-1.72~-0.81,P<0.00001)和P504S水平(MD=-0.64,95%CI=-0.70~-0.59,P<0.00001),差异均有统计学意义;可降低VEGF水平,但差异无统计学意义(MD=-131.53,95%CI=-281.69~18.64,P=0.09)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。漏斗图不对称,考虑存在发表偏倚。结论:Meta分析结果提示,戈舍瑞林联合比卡鲁胺用于前列腺癌术后的疗效较佳、安全性高,是一种有效的前列腺癌术后治疗方法。展开更多
文摘BACKGROUND Leiomyomatosis peritonealis disseminata(LPD)is a rare condition characterized by multiple pelvic and abdominal nodules,which are composed of smoothmuscle cells.To date,no more than 200 cases have been reported.The diagnosis of LPD is difficult and there are no guidelines on the treatment of LPD.Currently,surgical excision is the mainstay.However,hormone blockade therapy can be an alternative choice.CASE SUMMARY A 33-year-old female patient with abdominal discomfort and palpable abdominal masses was admitted to our hospital.She had undergone four surgeries related to uterine leiomyoma in the past 8 years.Computed tomography revealed multiple nodules scattered within the abdominal wall and peritoneal cavity.Her symptoms and the result of the core-needle biopsy were consistent with LPD.The patient refused surgery and was then treated with tamoxifen,ulipristal acetate(a selective progesterone receptor modulator),and goserelin acetate(a gonadotropin-releasing hormone agonist).Both tamoxifen and ulipristal acetate were not effective in controlling the disease progression.However,the patient achieved an excellent response when goserelin acetate was attempted with relieved syndromes and obvious shrinkage of nodules.The largest nodule showed a 25%decrease in the sum of the longest diameters from pretreatment to posttreatment.Up to now,2 years have elapsed and the patient remains asymptomatic and there is no development of further nodules.CONCLUSION Goserelin acetate is effective for the management of LPD.The long-term use of goserelin acetate is thought to be safe and effective.Hormone blockade therapy can replace repeated surgical excision in recurrent patients.
文摘Objective:Real-word data on long-acting luteinizing hormone-releasing hormone(LHRH)agonists in Chinese patients with prostate cancer are limited.This study aimed to determine the real-world effectiveness and safety of the LHRH agonist,goserelin,particularly the long-acting 10.8-mg depot formulation,and the follow-up patterns among Chinese prostate cancer patients.Methods:This was a multicenter,prospective,observational study in hormone treatment-na?ve patients with localized or locally advanced prostate cancer who were prescribed goserelin 10.8-mg depot every 12 weeks or 3.6-mg depot every 4 weeks with or without an anti-androgen.The patients had follow-up evaluations for 26 weeks.The primary outcome was the effectiveness of goserelin in reducing serum testosterone and prostate-specific antigen(PSA)levels.The secondary outcomes included testosterone and PSA levels,attainment of chemical castration(serum testosterone<50 ng/d L),and goserelin safety.The exploratory outcome was the monitoring pattern for serum testosterone and PSA.All analyses were descriptive.Results:Between September 2017 and December 2019,a total of 294 eligible patients received≥1 dose of goserelin;287 patients(97.6%)were treated with goserelin 10.8-mg depot.At week 24±2,the changes from baseline[standard deviation(95%confidence interval)]in serum testosterone(n=99)and PSA(n=131)were-401.0 ng/d L[308.4 ng/d L(-462.5,-339.5 ng/d L)]and-35.4 ng/m L[104.4 ng/m L(-53.5,-17.4 ng/m L)],respectively.Of 112 evaluable patients,100(90.2%)achieved a serum testosterone level<50 ng/d L.Treatment-emergent adverse events(TEAEs)and severe TEAEs occurred in 37.1%and 10.2%of patients,respectively.The mean testing frequency(standard deviation)was 1.6(1.5)for testosterone and 2.2(1.6)for PSA.Conclusions:Goserelin 10.8-mg depot effectively achieved and maintained castration and was well-tolerated in Chinese patients with localized and locally advanced prostate cancer.
文摘Background:Few studies compared the effectiveness of the 3-monthly goserelin 10.8-mg and the monthly 3.6-mg depot in inducing ovarian function suppression for premenopausal patients with hormone receptor positive(HR+)breast cancer.We conducted a large-scale real-world study(RWS)in China to validate the non-inferiority of goserelin 10.8-mg to the 3.6-mg depot.Methods:This multicenter,retrospective-prospective,non-inferiority study compared goserelin 10.8-mg with 3.6-mg in suppressing estradiol(E2)levels in premenopausal and perimenopausal patients with HR+breast cancer.Eligible patients were identified,and their demographic and clinical data were obtained from hospital medical records.The observation period was 28 weeks.Propensity score matching(PSM)ensured baseline comparability.The primary endpoint was the proportion of patients with E2 suppression to postmenopausal level at Week 12±4.Difference in proportions and 95%CI was calculated by Newcombe-Wilson score method.The non-inferiority margin was-10%.Subgroup and sensitivity analyses assessed result robustness.Results:From 1st January,2015 to 15th December,2023,15,629 patients from 16 hospitals nationwide were screened,with 1,060 eligible patients included in the full analysis set(3.6-mg group:678;10.8-mg group:382).Post-PSM,the primary endpoint was analyzed in 590 patients(295 in each group).At Week 12±4,the proportion of patients with E2 suppression was 99.1%(95%CI:96.9%-99.8%)for goserelin 10.8-mg and 95.3%(95%CI:91.0%-97.6%)for goserelin 3.6-mg.The difference was 3.8%(95%CI:0.6%-8.1%)with the lower limit of 95%CI greater than the non-inferiority margin.All subgroup analyses,including those based on age(≤45 or>45 years)and previous chemotherapy(yes/no),and all sensitivity analyses on the primary endpoint were consistent with the main analysis.
