Tasaka Nobutaka, Matsumoto Koji, Satoh Toyomi, Minaguchi Takeo, Onuki Mamiko, Ochi Hiroyuki, Tanaka Yumiko O, Sakata Akiko, Noguchi Masayuki, Yoshikawa Hiroyuki
Department of Obstetrics and Gynecology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575 Japan.
Springerplus. 2013 Nov 20;2:618. doi: 10.1186/2193-1801-2-618. eCollection 2013.
Dienogest is a novel synthesized progestin used for treatment of endometriosis. This is the first case report describing a therapeutic effect of dienogest on a gynecologic malignancy. The patient was a 44-year-old woman with advanced adenosarcoma arising from the endometriosis in the rectovaginal space and infiltrating the left pelvic wall, left ureter, rectum and vagina. The residual tumor after tumor debulking surgery was resistant to both chemotherapy and radiotherapy. Dienogest was used as a substitute for medroxyprogesterone acetate because of the presence of deep vein thrombosis. Based on the RECIST criteria, partial response was obtained with oral dienogest therapy at six months and the serum CA125 level also decreased from 70 U/ml to 16 U/ml. The tumor remained stable up to 21 months. Thromboembolism or other adverse effects did not occur during the dienogest therapy. Dienogest may be useful for the treatment of adenosarcoma arising from endometriosis.
地诺孕素是一种用于治疗子宫内膜异位症的新型合成孕激素。这是首例描述地诺孕素对妇科恶性肿瘤治疗效果的病例报告。该患者为一名44岁女性，患有源于直肠阴道间隙子宫内膜异位症的晚期腺肉瘤，肿瘤侵犯左侧盆腔壁、左侧输尿管、直肠和阴道。肿瘤细胞减灭术后的残留肿瘤对化疗和放疗均耐药。由于存在深静脉血栓形成，地诺孕素被用作醋酸甲羟孕酮的替代药物。根据RECIST标准，口服地诺孕素治疗6个月后获得部分缓解，血清CA125水平也从70 U/ml降至16 U/ml。肿瘤在21个月内保持稳定。地诺孕素治疗期间未发生血栓栓塞或其他不良反应。地诺孕素可能对治疗源于子宫内膜异位症的腺肉瘤有用。
