CLINICAL EFFECTS OF CHEMICAL HYPOPHYSECTOMY

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  • 前立腺癌末期患者に対する経蝶形骨洞
  • 下垂体アルコールブロックの効果
  • Instillation of Ethanol into the Pituitary on Advanced Prostatic Carcinoma

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Chemical hypophysectomy—Instillation of ethanol into the pituitary—was carried out according to the method of Moricca with slight modification in 6 patients with prostatic carcinoma; once for 5 patients and twice for another.<br>All of them had suffered from intractable pain caused by widely spread bony metastasis.<br>Ethanol in total amount of 1.6 to 2.4ml was injected into the pituitary through less than three needles which were previously confirmed as being introduced into the sella turcica via a nostril route under televised fluoroscopy in lateral and AP views.<br>The results of chemical hypophysectomy were successful; complete relief of pain in 3 patients and marked improvement of pain in other 3 patients. The pain relief continued for 4 to 16 months.<br>The effect of the treatment on carcinoma tissue itself was monitored by serum acid phosphatase, which transiently increased in most patients immediately after the treatment and then markedly decreased in 4 patients, and normalized in one of the 4 patients. There were neither lethal side effects nor complications.<br>One of the major side effects was diabetes insipidus caused by destruction of posterior pituitary, but this was well controlled recently by indomethacine administration.<br>In conclusion, chemical hypophysectomy is obviously effective for improvement of clinical conditions, but the effect of the treatment on carcinoma tissue itself remains to be studied.

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