Importance of early tumour exacerbation in patients treated with long acting analogues of gonadotrophin releasing hormone for advanced prostatic cancer.

Left ventricular thrombi seen by ventriculography are a significant risk factor for stroke in open-heart surgery. Nature of deposits in a tubular membrane oxygenator after prolonged extracorporeal circulation: a scanning electromicroscopy study. the microcirculation of the cerebral cortex of dogs subjected to pulsatile and non-pulsatile flow during extracorporeal circulation. In: A propos du debit pulse. SHORT REPORTS Importance of early tumour exacerbation in patients treated with long acting analogues of gonadotrophin releasing hormone for advanced prostatic cancer We describe the transient stimulatory effect-"tumour flare"-that occurred in patients with locally advanced or metastatic symptomatic prostatic cancer who were treated with either buserelin (D-ser (TBU)6-LHRH ethylamide) or decapeptyl (D-(Trp)6-LHRH), agonist analogues of gonadotrophin releasing hormone. Forty six men aged 52-82 with symptomatic locally advanced or metastatic prostatic cancer were treated. Five patients received buserelin 200 [tg thrice daily, 17 buserelin 200 Ftg five times daily, and eight buserelin 400 [tg thrice daily intranasally, and five men were treated with monthly depot injections of buserelin calculated to release the compound at a mean rate of 150 [tg daily. Eleven patients received depot injections of decapeptyl, which released the drug at a mean rate of 50, 100, or 200 [tg daily over one month. Treatment was given for between one month and three years. All patients were assessed according to the criteria of the National Prostatic Cancer Project. Objective improvement occurred in 26 of the 35 patients treated with buserelin and eight of the 11 patients treated with decapeptyl. Seventeen of 32 with bone pain at presentation and one without, however, had increased symptoms. Pain was generally first noted to have increased at 12 hours, became maximal at 36 hours, and eased by the end of the first treatment week. A patient with pelvic lymphadenopathy developed lymphoedema, which resolved after one week of treatment. The 17 patients with increased bone pain experienced some additional problems. Four had increased lymphoedema, which was maximal at the end of the first treatment week and had resolved at one month. The serum creatinine concentration in one patient increased from 170 to 600 [tmol/l (1-92 to 6-79 mg/100 ml) at the eighth treatment day and decreased at the end of the second treatment week. The most serious case of tumour flare occurred in a patient presenting with bone pain and grade 4 weakness in the legs, who developed signs of compression of the cord with complete sphincter dysfunction and …