Gonzalez-Barcena D, Perez-Sanchez P, Ureta-Sanchez S, Berea Dominguez H, Graef-Sanchez A, Becerril Morales M, Comaru-Schally A M, Schally A V
Prostate. 1985;7(1):21-30. doi: 10.1002/pros.2990070104.
Twenty patients with stage D2 prostatic carcinoma were treated for up to 18 months with D-Trp-6-LH-RH. Results of more than 3 months of treatment on these 20 patients are reported. The analog was given SC once daily at a dose of 1,000 micrograms/day. All patients had bone pain and high levels of acid and alkaline phosphatase. After the first week of D-Trp-6-LH-RH administration, major decreases in bone pain and reversal of the signs of prostatism were observed. Acid phosphatase gradually fell, achieving normal values after 12 weeks. Initial plasma testosterone was within normal limits, but during treatment with D-Trp-6-LH-RH it fell to castration levels. Resting values of PRL, GH, TSH, and cortisol did not show significant changes. After TRH, TSH increased in five patients, but five did not respond. However, at 2 and 4 months, all patients released TSH in response to TRH. Two patients died during the treatment with D-Trp-6-LH-RH despite initial subjective responses and decreases in testosterone levels. The rise in acid phosphatase levels in these two patients was accompanied by a general deterioration, suggesting that they had androgen-independent cancer. One patient who developed progressive hepatic, bone, and pulmonary metastases in spite of previous orchiectomy was also treated with the analog. Three months later his acid phosphatase levels were within normal values, and partial regression of metastases was observed. These results demonstrate that D-Trp-6-LH-RH and other LH-RH agonists can be used as an effective endocrine therapy for advanced prostate carcinoma, thereby avoiding the side effects of estrogens or the psychological impact of surgical castration.
20例D2期前列腺癌患者接受了D-色氨酸-6-促黄体生成素释放激素（D-Trp-6-LH-RH）治疗，最长达18个月。本文报告了对这20例患者超过3个月的治疗结果。该类似物通过皮下注射给药，每日1次，剂量为1000微克/天。所有患者均有骨痛，且酸性和碱性磷酸酶水平较高。在给予D-Trp-6-LH-RH治疗的第一周后，观察到骨痛明显减轻，前列腺增生的体征得到逆转。酸性磷酸酶逐渐下降，12周后达到正常水平。初始血浆睾酮在正常范围内，但在D-Trp-6-LH-RH治疗期间降至去势水平。催乳素、生长激素、促甲状腺激素和皮质醇的静息值未显示出显著变化。给予促甲状腺激素释放激素（TRH）后，5例患者促甲状腺激素升高，但5例无反应。然而，在2个月和4个月时，所有患者对TRH均有促甲状腺激素释放反应。尽管最初有主观反应且睾酮水平下降，但仍有2例患者在D-Trp-6-LH-RH治疗期间死亡。这2例患者酸性磷酸酶水平升高，同时伴有全身状况恶化，提示他们患有雄激素非依赖性癌症。1例患者尽管之前接受过睾丸切除术，但仍出现了进行性肝、骨和肺转移，也接受了该类似物治疗。3个月后，他的酸性磷酸酶水平恢复正常，且转移灶出现部分消退。这些结果表明，D-Trp-6-LH-RH和其他促黄体生成素释放激素激动剂可作为晚期前列腺癌的有效内分泌治疗方法，从而避免雌激素的副作用或手术去势的心理影响。
