Goserelin is a hormone regulator, commonly used to treat hormone-dependent diseases such as breast cancer, prostate cancer, endometriosis, etc. Its therapeutic effect is mainly achieved by inhibiting the secretion of sex hormones and reducing the hormone level in the patient's body, so as to inhibit tumor growth or relieve symptoms. Goserelin can also be used as an adjuvant treatment for some reproductive system-related diseases, such as infertility. This article provides a detailed description of the indications, usage and dosage of Goserelin.

(I) Indications

1. B2-C prostate cancer

Goserelin is suitable for the combined treatment of localized T2b-T4 (B2-C) prostate cancer with flutamide. Goserelin and flutamide treatment should be started 8 weeks before the start of radiotherapy and continued during radiotherapy.

2. Prostate cancer

Goserelin is suitable for the palliative treatment of advanced prostate cancer.

3. Endometriosis

Goserelin is suitable for the treatment of endometriosis, including pain relief and reduction of endometriosis lesions during treatment. The experience of Goserelin in the treatment of endometriosis is limited to women aged 18 years and older, with treatment for 6 months.

4. Endometrial thinning

Goserelin is used as an endometrial thinner before endometrial ablation for dysfunctional uterine bleeding.

5. Advanced breast cancer

Goserelin is indicated for the palliative treatment of advanced breast cancer in premenopausal and perimenopausal women. Estrogen and progesterone receptor values may help predict whether Goserelin treatment may be beneficial. The automatic safety feature of the syringe helps prevent needlestick injuries.

(II) Dosage and administration

The dose of Goserelin is 3.6 mg, which should be administered subcutaneously to the anterior abdominal wall below the umbilicus line every 28 days under the supervision of a physician using aseptic technique. Although delays of a few days are allowed, every effort should be made to adhere to the 28-day schedule.

1. Recommended dose

(1) B2-C prostate cancer

For patients with T2b-T4 (B2-C) prostate cancer, Goserelin combined with radiotherapy and flutamide should be started 8 weeks before the start of radiotherapy and continued during radiotherapy. Use a 3.6 mg depot of Goserelin 8 weeks before radiotherapy, followed by 10.8 mg of Goserelin 28 days later. Alternatively, 4 doses of 3.6 mg are given every 28 days, twice before radiotherapy and twice during radiotherapy.

(2) Prostate cancer

For the treatment of advanced prostate cancer, Goserelin is administered long-term unless clinically inappropriate.

(3) Endometriosis

For the treatment of endometriosis, the recommended duration of medication is 6 months. Currently, there is no clinical data showing the effect of Goserelin in the treatment of benign gynecological diseases for more than 6 months.

Since the safety data of retreatment are unclear, retreatment of endometriosis is not recommended. If symptoms of endometriosis recur after a course of treatment and further treatment with Goserelin is considered, bone density monitoring should be considered. Clinical studies have shown that the addition of hormone replacement therapy (estrogen and/or progesterone) to Goserelin can effectively reduce the bone mineral loss that occurs when Goserelin is used alone, without affecting the efficacy of Goserelin in relieving endometriosis. The addition of hormone replacement therapy can also reduce the occurrence of vasomotor symptoms and vaginal dryness associated with insufficient estrogen secretion. The optimal drug, dose, and duration of treatment have not yet been determined.

(4) Endometrial thinning

As an endometrial thinner before endometrial ablation, the recommended dose is 1-2 times (4 weeks apart). When one depot is used, surgery should be performed within four weeks. When two depots are used, surgery should be performed within two to four weeks after the use of the second depot.

(5) Breast cancer

For the treatment of advanced breast cancer, Goserelin is administered long-term unless clinically inappropriate.

(6) Kidney or liver damage

For patients with kidney or liver damage, there is no need to adjust the dosage.

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