To evaluate the outcomes of patients treated with cyclic administration of dienogest after ovarian endometriotic cystectomy, following the completion of treatment. We retrospectively evaluated 26 patients treated with dienogest (2 mg/day) after cystectomy (revised American Society for Reproductive Medicine [r-ASRM] stage III-IV) in a pilot study. Dienogest was administered cyclically, for a total of six cycles, each comprising three weeks on and one week off. Outcomes of interest included severity of menstrual pain and recurrence of cysts at baseline, during the immediate post-treatment period and at the final outpatient follow-up. The mean outpatient follow-up period was 45.0 months. The visual analog scale score for menstrual pain following 6 cycles of dienogest treatment was significantly lower than that at baseline; it remained low at the final follow-up. The recurrence rates of cysts were 4% and 21% at 24 and 48 months after the completion of dienogest treatment, respectively. Six patients with recurrent disease were all classified as having r-ASRM stage IV. Our results suggest that cyclic dienogest for six months after cystectomy could relieve menstrual pain and reduce the recurrence of cysts, for approximately four years. The necessary treatment period for patients with r-ASRM stage IV disease requires further study.
Aim/Background: The aim of this study was to investigate the association between 5-fluorouracil (5-FU)-related adverse events (AEs) in Japanese patients with gastrointestinal cancer treated with 5-FU and the patients genotypes of DPYD. Methods: Sequence analyses of 20 polymorphisms in DPYD were performed using genomic DNA extracted from peripheral blood mononuclear cells of 103 patients with gastric (n = 34) or colorectal (n = 69) cancer. The 5-FU-related AEs of in these 103 patients were evaluated based on the medical records of patients in each of three groups: the intravenous administration group (i.v. group, n = 51), oral administration group ( p.o. group, n = 106), and all-regimens group (both i.v. and p.o. group, n = 157). The associations between the incidence of AEs and each genotype were statistically analyzed. Results: Three single-nucleotide polymorphisms (SNPs) of DPYD were identified; c.496A > G (n = 7), c.1905 + 1G > A (n = 1), and c.2303C > A (n = 3), those of which were all heterozygote. Among them, five of seven c.496A > G individuals suffered from grade 3 neutropenia (n = 1), fatigue (n = 3), and diarrhea (n = 2). One of three c.2303C > A individuals suffered from grade 3 neutropenia and fatigue. The one c.1905 + 1G > A individual suffered from grade 4 neutropenia and grade 3 hyperbilirubinemia. The patients in the all-regimens group carrying any one of three DPYD SNPs showed statistically significant associations with the incidence of AEs of any type and fatigue. A similar trend was observed in the p.o. group, but not in the i.v. group. Conclusions: These findings suggest that the DPYD SNPs c.496A > G, c.1905 + 1G > A, and c.2303C > A might be predictive factors for the occurrence of severe 5-FU-related AEs. Disclosure: All authors have declared no conflicts of interest.
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