前立腺癌患者の抗男性ホルモン療法中における血漿FSH, LH並びに Testosterone 値の推移について

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  • EFFECT OF HORMONAL THERAPY ON PLASMA FSH, LH AND TESTOSTERONE LEVELS IN PROSTATIC CANCER
  • ゼンリツセンガン カンジャ ノ コウ ダンセイ ホルモン リョウホウチュウ ニ

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In 14 patients between 44 and 85 of age who were orchidectomized for prostatic cancer, and of whom most were undergoing additional treatments with anti-androgenic hormones, plasma levels of FSH, LH, and testosterone were determined, and in 12 of them a LH-RH loading test was performed to examine its effects on the pituitary secretory function, as well as on the adrenal cortical function of testosterone secretion. In two cases out of the 12, a HCG loading test was also applied to study response of the adrenal gland to HCG. Results show that the combined therapy of orchidectomy with subsequent anti-androgenic hormone administration caused a rapid fall of the plasma levels of FSH, LH, and testosterone, whereas in the early stage the pituitary continued to respond to LH-RH loading. Clinically, pain caused by urination and from bone metastases all disappeared without much problem, though the prostatic tumor itself was without appreciable change. After more than 6 month's application of anti-androgenic hormones, the plasma level of testosterone began to rise, and the pitutary response to LH-RH became depressed. However, a slight increase in plasma LH stimulated the sensitive adrenal to produce more testosterone. However, there was no correlation between the increase in plasma testosterone and the aggravation of the tumor. Medical adrenalectomy in addition to orchidectomy and hormonal therapy worked to reduce testosterone in plasma to negligible amounts, alleviating pains of bone metastases and troubles with urination. In one case which underwent only orchidectomy with no supplementary treatments, plasma levels of FSH, LH, and also testosterone were observed to increase 2 years after the orchidectomy, with the pituitary reacting positively to LH-RH loading; the condition of prostatic tumor became aggravated and no appreciable improvement in urination.

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