Treatment of endometrial cancer with GnRH analogs.

Given the small number of side effects, GnRH may be a useful and ideal drug for new therapeutic hormonal approaches in many cases of both invasive and noninvasive endometrial cancer. The hypoestrogenic state thus induced as well as a local effect may lead to pronounced regression of the tumor. Any future therapy should, however, always be tailored to meet individual needs. The use of GnRH agonists may be advocated in the following circumstances: 1. In pronounced endometrial hyperplasia and adenomatous hyperplasia (particularly relevant in those cases where hysterectomy is not desirable, e.g., in young patients who have not yet completed their families). 2. In patients with endometrial cancer where surgery is contraindicated or refused. 3. In addition to or as a substitute for radium treatment preoperatively to reduce uterine volume (myomas) to make surgery technically easier; to devitalize the tumor, stop menorrhagia, and improve anemia. 4. In advanced cases as an adjunct to radiotherapy and gestagens. It is possible that this will produce synergistic effects. 5. As adjuvant treatment (replacing gestagens?) in primary stages. 6. In relapses of endometrial cancer, refractory to conventional therapy, and in pulmonary metastases.