As a hormone regulator, Goserelin mainly inhibits the secretion of gonadotropin-releasing hormone (GnRH). By simulating and continuously stimulating GnRH receptors, Goserelin can inhibit the production of gonadotropin by the anterior pituitary gland, ultimately reducing the level of sex hormones in the body. This regulatory effect can be used to treat some hormone-dependent diseases, such as breast cancer, prostate cancer, endometriosis, etc.
Dosage and Administration of Goserelin
The dose of Goserelin is 3.6 mg, which should be administered subcutaneously to the anterior abdominal wall below the navel line every 28 days under the supervision of a physician using aseptic techniques. Although delays of a few days are allowed, every effort should be made to adhere to the 28-day schedule.
1. Recommended dose
(1) Stage B2-C prostate cancer
For patients with stage T2b-T4 (stage B2-C) prostate cancer, when Goserelin is combined with radiotherapy and flutamide, treatment should be started 8 weeks before the start of radiotherapy and continued during radiotherapy. Goserelin 3.6 mg depot is used 8 weeks before radiotherapy, followed by Goserelin 10.8 mg for 28 days. Alternatively, 3.6 mg is administered 4 times 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 on the efficacy 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.
(4) Endometrial thinning
As an endometrial thinner before endometrial ablation, the recommended dose is 1-2 times (4 weeks apart). When one reservoir is used, surgery should be performed within four weeks. When two reservoirs are used, surgery should be performed within two to four weeks of using the second reservoir.
(5) Breast cancer
For the treatment of advanced breast cancer, Goserelin is administered long-term unless clinically inappropriate.
(6) Renal or hepatic impairment
For patients with renal or hepatic impairment, no dose adjustment is required.
2. Administration
(1) Place the patient in a comfortable position with the upper body slightly elevated. Prepare an area on the anterior abdominal wall below the umbilicus line with an alcohol swab. Caution should be exercised when injecting Goserelin into the anterior abdominal wall due to proximity to the inferior epigastric artery and its branches.
(2) Check the foil bag and syringe for damage. Remove the syringe from the opened foil bag and hold the syringe at a slight angle to the light. Check that at least part of the Goserelin implant is visible.
(3) Grasp the red plastic safety label, pull it off the syringe, and discard it. Remove the needle cover. Unlike liquid injections, there is no need to remove air bubbles, as doing so may dislodge the Goserelin implant.
(4) Wrap the syringe around the protective sleeve and, using aseptic technique, pinch the patient's anterior abdominal skin below the umbilicus line. With the bevel of the needle facing up and at a 30-45 degree angle to the skin, insert the needle in a continuous motion until the protective sleeve contacts the patient's skin.
Note: The Goserelin syringe should not be used for aspiration. If the hypodermic needle penetrates a large vessel, blood will be immediately visible in the injection cavity. If a vessel is penetrated, remove the needle and inject elsewhere with a new syringe. Monitor the patient for signs or symptoms of abdominal bleeding. Exercise extreme caution when administering Goserelin to patients with a low BMI and/or those receiving full-dose anticoagulation therapy.
(5) Do not pierce the muscle or peritoneum.
(6) To use the Goserelin implant and activate the protective sleeve, hold the barrel with your fingers and depress the plunger until it can no longer be depressed. If the plunger is not fully depressed, the protective sleeve will not activate. When the protective cover "clicks", the protective cover will automatically begin to slide over the needle and the needle cannot be retracted.
(7) Remove the needle and allow the protective cover to slide over and cover the needle. Dispose of the syringe in an approved sharps container and, in the unlikely event that surgical removal of Goserelin is required, can be located by ultrasound.
