mitolactol and Carcinoma--Squamous-Cell

In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. Attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure.

Topics: Antineoplastic Agents, Alkylating; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Cutaneous Fistula; Fistula; Humans; Jaw; Jaw Diseases; Male; Methotrexate; Middle Aged; Mitolactol; Mouth Neoplasms; Oral Hygiene; Orthognathic Surgical Procedures; Osteoradionecrosis; Osteotomy; Postoperative Complications; Premedication; Radioisotope Teletherapy; Radiotherapy; Scattering, Radiation; Surgery, Plastic; Surgical Flaps; Tomography, X-Ray Computed; Tongue Neoplasms; Tooth Diseases; Tooth Extraction; Vincristine; Wound Healing

The purpose of this clinicopathological study was to evaluate the effects and efficiency of combined neoadjuvant chemotherapy related to surgical margin. 100 consecutively treated squamous cell cancer patients receiving a combined neoadjuvant therapy were selected (Bleomycin-Vincristin-Methotrexate (BVM) or BVM + Mitolactol or BVM + Cisplatin). After three courses of chemotherapy, the patients were operated on. The largest diameter of the primary tumors was compared before and after chemotherapy. In the surgical specimen, the involvement of surgical margin was assessed. The largest diameter before chemotherapy was: T2 30%; T3 55%; T4A 15%. After chemotherapy, the rest tumor was assessed in the surgical specimen as: no rest 11%; <2 cm 57%; 2-4 cm 28%; 4-6 cm 4%. The no rest and <2 cm (optimal operability) tumor was observed in T2: 94%; in T3: 73%; in the T4A: 0%. Severe side effects (Grade III-IV) were not observed. There was a significant decrease in size (P < 0.0001). Of the 100 surgical specimens, 83% had clear-, 9% close- and 8% involved margins. From T4A, there was a 40% (6 patients) involved margin. Based on the significantly better size and operability of primary T2-3, the mild side effects and the high (83%) percentage of clear surgical margins, that is better than other (without preoperative chemotherapy) results, sought the use of chemotherapy is recommended before surgery. Due to the 40% involved margin, we don't suggest surgery in T4A.

Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Female; Humans; Male; Methotrexate; Middle Aged; Mitolactol; Mouth Neoplasms; Neoadjuvant Therapy; Neoplasm Staging; Oral Surgical Procedures; Physicians; Surgery, Oral; Vincristine

Cisplatin, mitolactol (dibromodulcitol), and ifosfamide have been the most active single agents in squamous carcinoma of the cervix identified so far by the Gynecologic Oncology Group (GOG). Combinations of cisplatin plus ifosfamide and cisplatin plus mitolactol are prospectively compared with cisplatin alone.. Patients were randomized to receive cisplatin 50 mg/m2 or the same dose of cisplatin plus mitolactol (C + M) 180 mg/m2 orally on days 2 to 6, or cisplatin plus ifosfamide (CIFX) 5 g/m2 given as a 24-hour infusion plus mesna 6 g/m2 during and for 12 hours after the ifosfamide infusion, every 3 weeks for up to six courses. Of 454 patients entered, 438 were eligible and analyzed for response and survival.. CIFX had a higher response rate (31.1% v 17.8%, p = .004) and longer progression-free survival (PFS) time (P = .003) compared with cisplatin alone. The median times to progression or death were 4.6 and 3.2 months, respectively. C + M showed no significant improvement in these parameters compared with cisplatin alone. Survival was associated with initial performance score (PS; 0 was more favorable; P < .001) and with age (younger was unfavorable, P = .025). There was no significant difference in overall survival between cisplatin and either of the combinations. Leukopenia, renal toxicity, peripheral neurotoxicity, and CNS toxicity were more frequent with CIFX (P < .05).. CIFX improved the response rate and PFS duration in advanced cervix cancer compared with cisplatin alone, but at the cost of greater toxicity and with no improvement in survival.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Cisplatin; Female; Humans; Ifosfamide; Middle Aged; Mitolactol; Prospective Studies; Remission Induction; Survival Analysis; Uterine Cervical Neoplasms

From January 1976, 50 patients with squamous cell cancer of the head and neck were treated with telecobalt preoperative irradiation followed by appropriate surgery. Another group of 50 patients, who matched in risk factors and stage of disease, were treated with preoperative chemotherapy and surgery. Chemotherapy consisted of bleomycin, vincristine, mitolactol and methotrexate. All patients received 3 courses. Surgery was performed 2-3 weeks post-chemotherapy or 4-6 weeks postradiotherapy. Forty-four percent of the patients in the radiotherapy group showed recurrences, while 30% of the patients had recurrence in the chemotherapy group. The overall 3-year survival rate was 66% in the chemotherapy group and 57% in the radiation therapy group, with no statistical difference.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Humans; Male; Methotrexate; Middle Aged; Mitolactol; Mouth Neoplasms; Preoperative Care; Vincristine

Sixty patients with advanced squamous cell carcinoma of the cervix (SCC) who had received no prior chemotherapy were entered onto a study of mitolactol (dibromodulcitol [DBD]). The drug was administered orally at an initial dose of 180 mg/m2 per day for 10 days and repeated every 4 weeks. There were 55 evaluable patients, of whom one (2%) had a complete response (CR), and 15 (27%) had a partial response (PR), (CR plus PR, 29%). A 95% confidence interval for the true response rate is 18.8% to 42.1%. Myelosuppression was appreciable at this dose and schedule, with 13 patients experiencing life-threatening thrombocytopenia and two drug-related deaths. The level of activity in this disease encourages us to determine a tolerable dose of this drug in combination with cisplatin for further study.

Topics: Adult; Aged; Bone Marrow; Carcinoma, Squamous Cell; Drug Evaluation; Female; Humans; Middle Aged; Mitolactol; Multicenter Studies as Topic; Uterine Cervical Neoplasms

Topics: Adult; Aged; Carcinoma, Squamous Cell; Clinical Trials as Topic; Drug Evaluation; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Mitolactol

A phase III study was designed comparing the effectiveness of Hexamethyl-melamine (NSC 13875) to Dibromodulcitol (NSC 104800) in lung carcinoma. 250 of the 316 patients entered on the study were stratified into groups according to stage of disease and cell type. The results showsed Hexamethylmelamine to be more effective in patients with squamous cell carcinoma and slightly superior to Dibromodulcitol in patients with anaplastic/undifferentiated cell carcinoma, whereas Dibromodulcitol proved to be more effective in patients with adenocarcinoma.

Topics: Adenocarcinoma; Altretamine; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Clinical Trials as Topic; Drug Evaluation; Humans; Leukopenia; Lung Neoplasms; Middle Aged; Mitolactol; Nausea; Thrombocytopenia; Triazines; Vomiting

A-431 squamous cell carcinoma cells were treated in vitro with either 4 Gy radiation of 15 (or 45) microg/ml dibromodulcitol (DBD), as well as with combined 4 Gy irradiation and DBD, with the latter as either a pretreatment or post-treatment. DBD alone or in combination with radiation had a greater effect on cell proliferation than the effect of radiation alone. The difference is due to a higher level of apoptosis induced by DBD, especially in conjunction with radiation. Such a combination may therefore be useful in the treatment of squamous cell carcinoma, which in general responds poorly to radiation therapy.

Topics: Antineoplastic Agents, Alkylating; Apoptosis; Carcinoma, Squamous Cell; Cell Division; Combined Modality Therapy; Dose-Response Relationship, Drug; Dose-Response Relationship, Radiation; Drug Screening Assays, Antitumor; Gamma Rays; Humans; Mitolactol; Mitosis; Proliferating Cell Nuclear Antigen; Proto-Oncogene Proteins c-bcl-2; Retinoblastoma Protein; Tumor Cells, Cultured; Tumor Suppressor Protein p53

Topics: Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Head and Neck Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Mitolactol

Antitumor activity has been documented in this pilot study utilizing mitolactol in patients with advanced carcinoma of the cervix. These results may in part be explained by optimal patient selection; however, the results do encourage further testing of this hexitol in this disease.

Topics: Adult; Carcinoma, Squamous Cell; Drug Evaluation; Female; Humans; Lung Neoplasms; Middle Aged; Mitolactol; Neoplasm Recurrence, Local; Time Factors; Uterine Cervical Neoplasms

Topics: Adult; Aged; Carcinoma, Squamous Cell; Female; Humans; Male; Middle Aged; Mitolactol; Papilloma; Urinary Bladder Neoplasms

In all cases of Guerin carcinoma of the rat the recurrence of the tumor in 7-10 days can be observed following surgical removal. Local treatment with Dibromodulcitol combined with intraperitoneal administration of the same drug results in delayed occurrence of tumor recurrences, the growth of which is slower, and in a significant increase of life span of the animals. In exceptional cases no recurrence appeared. The local treatment combined with intraperitoneal administration was the most effective. Peroral treatment was also effective although in a lesser degree.

Topics: Animals; Carcinoma, Squamous Cell; Cell Survival; Mitolactol; Neoplasm Recurrence, Local; Neoplasm Transplantation; Neoplasms, Experimental; Postoperative Complications; Rats; Syndrome; Transplantation, Homologous

Topics: Carcinoma, Squamous Cell; Humans; Laryngeal Neoplasms; Mitolactol; Respiratory Tract Neoplasms; Tonsillar Neoplasms