Toyoko Yamato

Treatment of androgen-independent prostate cancer with dexamethasone: A prospective study in stage D2 patients

In order to evaluate the efficacy of dexamethasone in the treatment of Japanese men with androgen‐independent prostate cancer, a prospective study was conducted using prostate‐specific antigen (PSA) as a primary end‐point.

Optimal Starting Time for Flutamide to Prevent Disease Flare in Prostate Cancer Patients Treated with a Gonadotropin-Releasing Hormone Agonist

Objective: Flare-up phenomena, such as an increase in prostate-specific antigen (PSA) and/or deterioration of symptoms, are observed in some patients undergoing gonadotropin-releasing hormone (GnRH) agonist therapy. This study was carried out to determine the optimal time for starting the administration of flutamide to prevent flare-up phenomena. Patients and Methods: Twenty-six patients with prostate cancer and elevated serum levels of PSA were randomly assigned to 5 groups. Group A patients (n = 6) were treated with a subcutaneous injection of 3.75 mg leuprorelin acetate depot alone. Group B, C, D and E patients (5 patients in each group) were treated with 375 mg/day of orally administered flutamide combined with leuprorelin. Flutamide was initiated on the day of leuprorelin injection in group B, and at 1, 2 and 4 weeks before leuprorelin injection in groups C, D and E, respectively. Serum PSA and testosterone levels were measured in each patient. Results: Pretreatment with flutamide increased the serum testosterone level, but the testosterone surge after leuprorelin administration was almost the same in all 5 treatment groups. In patients who had been treated with flutamide in combination with leuprorelin, the mean PSA level did not exceed the pretreatment levels after leuprorelin administration. The rate of decrease in PSA in the group receiving simultaneous administration of flutamide with leuprorelin showed a decline comparable to that during the period before leuprorelin administration in the flutamide pretreatment groups. Conclusion: Simultaneous administration of flutamide with a GnRH agonist is sufficient to prevent flare-up phenomena.

The Effect of Hochuekkito on Female Stress Urinary Incontinence

女性腹圧性尿失禁患者に対して補中益気湯を4週間投与し，その臨床的有用性を検討した。女性腹圧性尿失禁患者13名に対し，食前に1日3回補中益気湯7.5gを4週間投与した。治療前，治療1カ月後に，VAS（visual analog scale），IQOL（Incontinence-QOL）による自覚症状の変化を観察し，また排尿日誌を用いて排尿回数，尿失禁回数の変化，パッドテストによる失禁量の変化，尿流測定による他覚的な排尿状態の変化の確認を行った。また投与終了時の患者の満足度も検討した。結果は有意差は認めなかったが，VAS，IQOLスコア，いずれも改善傾向であった。パッドテスト，失禁回数は減少傾向であった。排尿回数，最大尿流量は変化なく，患者満足度は高かった。BMI別で検討すると非肥満型では有意にVAS, IQOLの改善を認めた。補中益気湯は排尿状態に影響を及ぼさず，尿失禁の程度，証などを考慮すれば有効であることが示唆された。副作用として重篤なものは認めなかった。