Progestogens in the treatment of carcinoma of the endometrium.
All patients in this study had advanced endometrical carcinoma. In the first part of the study 17-alpha-hydroxyprogesterone caproate was given intramuscularly to 7 patients at 750 mg/week, 25 patients at 1500 mg/week, and 9 patients at 3000 mg/week. In the second part of the study a new type of progestogen, dihydroxyprogesterone acetophenide, was given intramuscularly to 34 patients at 900 mg/week. Objective regression was defined as a reduction in size of more than 50% of all tumors and recalcification of osseous lesions for a period of at least 2 months, with no evidence of any disease progression. Objective regression occurred in 10 (24.4%) of the patients in the first part of the study and in 9 (26.5%) of those in the second part of the study. The mean durations of improvement were in excess of 35 months and in excess of 18.5 months, respectively (shorter interval for latter partly because of shorter term of study). Subjective improvement occurred in 13 of the 19 patients with objective regression and in 10 of the 56 who had no objective regression. The mean duration of treatment of the 19 favorable responders was 7-fold greater than that of patients who showed no improvement (p less than .0005). 9 of the 19 responders (47%) and 1 of the 56 nonresponders (1.8%) are still alive. The responders characteristically had slowly growing tumors deemed hormonally independent carcinomas. Pulmonary lesions responded the best. There are no contraindications to the use of sythetic progestogens in patients with disseminated endometrial carcinoma.