peplomycin and Head-and-Neck-Neoplasms

Topics: Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Cisplatin; Combined Modality Therapy; Drug Combinations; Female; Head and Neck Neoplasms; Humans; Male; Maxillary Sinus Neoplasms; Peplomycin; Survival Rate; Tegafur; Uracil

Pulmonary toxicity was less frequent in pepleomycin treatment of squamous cell carcinoma than in bleomycin treatment. The tumor-regressing effect appeared at about day 10 of pepleomycin treatment, and at about day 21 of bleomycin treatment. The cumulative dose of pepleomycin to complete remission was smaller than that of bleomycin. Pepleomycin is effective against bleomycin-sensitive malignancies: squamous cell carcinoma and Hodgkin's disease. It is more effective than bleomycin against lymph node metastases. Pepleomycin may have a broader antitumor spectrum: prostatic carcinoma responded.

Topics: Antibiotics, Antineoplastic; Bleomycin; Drug Evaluation; Drug Resistance; Female; Head and Neck Neoplasms; Humans; Lymphoma; Male; Middle Aged; Neoplasm Metastasis; Peplomycin; Prostatic Neoplasms; Skin Neoplasms

Thirty two patients with inoperable head and neck cancer seen at Jichi Medical School Hospital during the period 1978 to 1995 were analyzed. Distribution of the affected site was as follows: 15 cases of oropharynx, 12 of hypopharynx, and 3 of larynx. In order to study a better performance status, prognosis and side effects were compared between radiotherapy alone (17 patients) and combined radiochemotherapy (15 patients). Patients who received the combined therapy survived longer than those patients who received radiotherapy alone. Moreover, high QOL was obtained longer in the combined therapy. Therefore, we conclude that radiotherapy should be combined with chemotherapy for cases with inoperable head and neck cancer.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Cisplatin; Female; Fluorouracil; Head and Neck Neoplasms; Humans; Male; Middle Aged; Peplomycin; Quality of Life; Treatment Outcome

From November 1993 to December 1994, a prospective multi-centre phase II clinical trial was done in 137 patients with advanced cancer on China-made pepleomycin (PEP). PEP was effective in patients with cancer of the head and neck, malignant lymphmo and lung cancer, with response rate of 66.7%, 50% and 30%, respectively. The major adverse reactions were fever and mild gastrointestinal reaction. In the controlled study of combination chemotherapy with China-made and Japan-made PEP, the response rates and side effects were similar. The results indicate that China made PEP can be used in lieu of that made in Japan.

Topics: Adolescent; Adult; Aged; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Female; Head and Neck Neoplasms; Humans; Lung Neoplasms; Lymphoma; Male; Middle Aged; Peplomycin; Prospective Studies

We investigated the clinical effects and toxicity of chemotherapy with Cisplatin (CDDP) for head and neck cancer as the third joint research project of the Tokai Meeting for Head and Neck Tumors. The cases were examined at the cooperating institutions from September 1986 to March 1988. The subjects were 93 cases consisting of 66 patients (intravenous infusion: 47 cases; intraarterial infusion: 19 cases) of PP therapy (CDDP + PEP), 16 cases of PF therapy (CDDP + 5-FU) and 11 cases of PPV therapy (CDDP + PEP + VCR). The regimens of PP therapy were: CDDP 50-100 mg/body x 1 day, PEP 5 mg/body x 5 days (i.v.), and CDDP 10-20 mg/body x 5 days, PEP 5-10 mg/body x 5 days (i.a.). In the regimen of PF therapy, CDDP 80-100 mg/body x 1 day and 5-FU 750-1,000 mg/body x 5 days were administered. In the regimen of PPV therapy, CDDP 80-100 mg/body x 1 day, PEP 5 mg/body x 5 days and VCR 1 mg/body x 1 day were administered. As a rule, two courses of each of the regimens were performed. The total dose of CDDP in intraarterial infusion of PP therapy was significantly less than in intravenous infusion. The major results were as follows: 1) Total response rate was 57.0% on the average, and this was not significantly different among the regimens. 2) The response rate of intraarterial infusion of PP therapy was as high as that for intravenous infusion in spite of the lower CDDP dose. 3) The response rate of oral cavity was significantly higher than that of nasal cavity and paranasal sinuses. 4) In the squamous cell carcinoma, the response rate of the well differentiated type was significantly higher than that of the poorly differentiated type. 5) The leukocyte counts significantly decreased with the intravenous infusion of PP therapy, PF therapy and PPV therapy. 6) The platelet counts significantly decreased with PPV therapy. 7) There were no significant changes with time with Ccr and PaO2 of PP therapy. 8) The frequency of toxicities such as nausea and vomiting was high in the intravenous infusion of PP therapy, PF therapy and PPV therapy. However, the frequency of toxicity was low in the intraarterial infusion of PP therapy.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Female; Fluorouracil; Head and Neck Neoplasms; Humans; Japan; Leukopenia; Male; Middle Aged; Nausea; Peplomycin; Remission Induction; Thrombocytopenia; Vincristine; Vomiting

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Clinical Trials as Topic; Double-Blind Method; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Mitomycin; Mitomycins; Peplomycin; Vincristine

The evolution of therapy for malignant ovarian germ cell tumors is one of the true success stories in oncology. Treatment outcome has improved greatly thanks to cisplatin-based combination chemotherapy. According to the well-established treatment guidelines for advanced cases, we treated a case of stage IV undifferentiated germ cell tumor in which we were able to preserve the patient's fertility. We concluded that the PEP regimen is an effective treatment for the patient with metastatic germ cell tumor.

Topics: Adult; Airway Obstruction; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Diagnosis, Differential; Dysgerminoma; Etoposide; Female; Head and Neck Neoplasms; Humans; Neoplasm Staging; Peplomycin; Radionuclide Imaging; Tomography, X-Ray Computed

Results of chemotherapy for head and neck cancer are now improving owing to the development of concomitant use of chemotherapeutic agents such as cisplatin or peplomycin. Concomitant use of the two agents has been favored clinically. However, fundamental study on the combination therapy has not been carried out sufficiently. In the present study we studied the cell kinetics of tumor cells by the combination of cisplatin and peplomycin using flowcytometric analysis and electron microscopy. Survival of tumor cells was lowest, when peplomycin was administrated 3 days after cisplatin. Cell kinetics showed an accumulation at the S and G2M stage in this situation, By the electron microscopic study, microvilli of tumor cells disappeared and the blebbing of tumor cells was observed, when cisplatin alone was administrated. However, when the combination of cisplatin and peplomycin was administrated to the tumor cells, tumor cells enlarged. The results suggest that the mechanism of combination therapy differed from the mechanism of cisplatin alone.

Topics: Antineoplastic Combined Chemotherapy Protocols; Cell Cycle; Cisplatin; Flow Cytometry; Head and Neck Neoplasms; Humans; Peplomycin

Head and neck cancer has hypoxic compartment. The hypoxic cells are resistant to anticancer drugs and thought to be one of the causes of recurrence. We examined effects of anticancer drugs on the hypoxic cells using HEp-2 human laryngeal cell line. Anticancer drugs, CDDP, peplomycin (PEP), 5-FU, THP-adriamycin (THP-ADR), and adriamycin (ADR), were incubated with cells in hypoxic condition (5% CO2 and 95% N2) for 72 hours. Drug effects were measured by proliferation rates (IC50). IC50 of PEP increased 22.89 folds in hypoxic cells. IC50 of CDDP and 5-FU also increased 1.86 and 2.27 folds respectively. However, IC50 of THP-ADR and ADR remained same in the hypoxic cells. It was proved that THP-ADR and ADR were effective for the hypoxic cells. The combination effect with THP-ADR and CDDP or PEP were more than additive against the hypoxic cells. It was suggested that the combination with THP-ADR and CDDP or PEP are effective for head and neck cancer which contains hypoxic cell compartment.

Topics: Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Cell Division; Cell Hypoxia; Cisplatin; Doxorubicin; Drug Synergism; Head and Neck Neoplasms; Humans; Peplomycin

A combined chemotherapy regimen (CP chemotherapy) consisting of cisplatin (CDDP) and peplomycin (PEP) was employed to treat patients with head and neck malignant tumors. More recently, PTP chemotherapy added to CP chemotherapy with THP-adriamycin (THP-ADM) was employed. We proceeded to investigate the efficacy of these two chemotherapeutic regimens. The subjects of this study included 22 patients in the CP chemotherapy group (18 males and four females). The PTP chemotherapeutic regimen was administered to 23 patients (18 males and five females). The results showed response rates of 54.5% for the CP chemotherapeutic regimen and 60.9% for the PTP chemotherapeutic regimen. In both treatment groups, the response rate decreased as the disease stage increased. As adverse reactions to the chemotherapeutic regimens, nausea and vomiting occurred in 63.6% of the CP group and 69.6% of the PTP group. Leukopenia was detected in 18.2% of the CP group and 69.6% of the PTP group, while alopecia was seen only in the PTP group, at an incidence of 39.1%. Cardiotoxicity was not detected in either group.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Doxorubicin; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Peplomycin

A group study of chemotherapy for head and neck squamous cell carcinoma, using CDDP, THP and PEP, was carried out on 32 cases at the department of Otolaryngology, University of Tokyo, and 7 affiliated hospitals. The combined chemotherapy, which we call "PTP therapy", consisted of 30 mg/m2 of THP on day 1, 70 mg/m2 of CDDP on day 2, and 5 mg/body/day of PEP on 4 successive days. The overall response rate was 78.1% (CR: 15.6%; PR: 62.5%). No major side effect was observed in any case. PTP therapy is useful in neoadjuvant chemotherapy.

Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Cisplatin; Dexamethasone; Doxorubicin; Drug Administration Schedule; Female; Fosfomycin; Head and Neck Neoplasms; Humans; Male; Metoclopramide; Middle Aged; Peplomycin

The chemosensitivity of various head and neck cancers was investigated with the 5-day rapid thymidine incorporation assay in soft agar culture. The evaluability rate was 56%. Head and neck cancers were sensitive in vitro, in decreasing order, to peplomycin, cisplatin, bleomycin, 5-fluorouracil, mitomycin C, and doxorubicin. Primary tumors and neck metastases exhibited the same sensitivity, with 21% of all specimens tested responding. In vitro chemosensitivities were similar among patients younger than 69 years of age and those older than 70. The predictive accuracy for sensitivity tested prospectively in five cases was 80% and that for resistance in four was 75%.

Topics: Aged; Antibiotics, Antineoplastic; Antineoplastic Agents; Bleomycin; Child; Cisplatin; Colonic Neoplasms; DNA, Neoplasm; Doxorubicin; Drug Screening Assays, Antitumor; Fluorouracil; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Methotrexate; Middle Aged; Mitomycins; Peplomycin; Remission Induction; Stomach Neoplasms; Thymidine; Tritium; Tumor Cells, Cultured

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Cyclophosphamide; Doxorubicin; Drug Screening Assays, Antitumor; Etoposide; Fluorouracil; Head and Neck Neoplasms; Humans; Methotrexate; Peplomycin; Tumor Cells, Cultured; Vincristine

Clinical results and experiences with the combination of radiotherapy and radiosensitizing agents to the head and neck cancers were reported. Each of chemotherapeutic agents, 5-FU, Bleomycin, Peplomycin, Adriamycin, and Cisplatin had a radiosensitizing effect, and was expected to affect additively to radiotherapy, which led to the improvement of local control rate, reduction of dose of external radiotherapy by 10-20 Gy/1-2 weeks or more, or reduction or dispersion of treatment-related injury. Especially in the management of head and neck cancers, those merits also led to the preservation of function or cosmesis and the saving from the radical surgery in a substantial amount of cases. It was also stressed that the judgment of whether or not the salvage surgery/brachytherapy is necessary must be critically done for each case during the RT course.

Topics: Bleomycin; Cisplatin; Combined Modality Therapy; Doxorubicin; Head and Neck Neoplasms; Humans; Peplomycin; Radiation-Sensitizing Agents; Radiotherapy Dosage

Clinical and histological effects of cis-platinum-peplomycin chemotherapy for metastatic lymph nodes were studied in 35 head and neck carcinomas. The results were as follows; 1. As the clinical effects, 4 cases revealed CR, 17 cases PR, and 16 cases NC. The response rate was 57%. 2. Histologically, 7 cases were classified as Grade III change, 1 case as Grade IIb change and 13 cases as Grade IIa change according to Ohboshi-Shimozato classification. 3. The clinical effects for the metastatic lymph nodes almost agreed to that for the primary lesion. 4. The histological effects for the metastatic lymph nodes almost agreed to that for the primary lesion. 5. The clinical effects for the metastatic lymph nodes did not always agree to the histological effects for it. 6. It was impossible to do radical treatment of metastatic lymph nodes with cis-platinum-peplomycin chemotherapy. In some cases, chemotherapy made it easy to do radical neck dissection.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Female; Head and Neck Neoplasms; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Peplomycin

Multi-drug chemotherapy containing cisplatin has been reported to be one of the most active chemotherapy regimens in advanced or recurrent head and neck squamous cell carcinoma. In this study, the current status of clinical investigation of combination chemotherapies is reviewed. And our data are presented in head and neck cancer with multi-drug chemotherapy containing cisplatin. Thirty-five patients of stage 3-4 and 70 patients with recurrent and/or metastatic head and neck squamous cell carcinoma were treated by multi-drug chemotherapy containing cisplatin, and radiotherapy and/or operation. The overall response rate was 71.4%, with 17.1% complete remission in previously untreated, locally advanced patients and 31.4% in recurrent or metastatic patients. Problems of chemotherapy combined with radiotherapy and future direction of clinical study in locally advanced or recurrent head and neck cancer are discussed.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Fluorouracil; Head and Neck Neoplasms; Humans; Methotrexate; Peplomycin

Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Male; Mice; Mice, Nude; Neoplasm Transplantation; Organoplatinum Compounds; Peplomycin

There are 4 modalities of combined radiotherapy and chemotherapy which include (1) concurrent radiotherapy and chemotherapy, (2) sequential use of radiotherapy and chemotherapy (pre-radiation chemotherapy), (3) pre-radiation chemotherapy followed by concurrent radiation and chemotherapy, and (4) alternating use of radiotherapy and chemotherapy based upon Looney's hypothesis. We studied concurrent use of radiotherapy and UFT by means of animal experimentation and clinical trials. The results obtained revealed that UFT was a most suitable agent together with 5-fluorouracil for concurrent application of radiotherapy and chemotherapy. Neoadjuvant chemotherapy including pre-radiation chemotherapy was also studied in cases of maxillary sinus carcinoma and nasopharyngeal carcinoma. From the results, it seemed desirable to use cisplatin and bleomycin analogs sequentially in combined chemotherapy and radiotherapy. Neo-adjuvant chemotherapy should be studied successively to improve local tumor control rates and prevent distant metastases. For future perspectives, new trials of alternating radiotherapy and chemotherapy based upon Looney's hypothesis seem necessary.

Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Head and Neck Neoplasms; Humans; Male; Maxillary Neoplasms; Mice; Mice, Inbred C57BL; Peplomycin

Spirometric parameters and transfer lung factor for carbon monoxide (TLCO) were determined in 14 cancer patients treated with pepleomycin at the dose of 10 mg twice weekly up to the cumulative dose of 200 mg. Mean values recorded after completion of therapy did not significantly differ from those recorded before treatment. Three patients pretreated with bleomycin had a fall in TLCO of more than 20% of pretreatment values. Three patients (2 of them pretreated with bleomycin) showed radiologic signs of pulmonary toxicity without instrumental signs of lung toxicity. In patients with no risk factors, no significant modifications in the tested parameters were observed after completion of therapy. These preliminary results suggest that, in the absence of risk factors, pepleomycin, may have no significant pulmonary toxicity at least up to the cumulative dose of 200 mg.

Topics: Adult; Aged; Bleomycin; Female; Head and Neck Neoplasms; Humans; Lung; Lymphoma; Male; Middle Aged; Peplomycin; Pulmonary Gas Exchange; Risk Factors; Vital Capacity

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

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Female; Head and Neck Neoplasms; Humans; Male; Methotrexate; Middle Aged; Peplomycin

Advanced squamous cell carcinoma of the head and neck, lung, esophagus, and uterine cervix is still a challenging cancer to the medical practice. We have treated 23 such patients with a combination of cis-platinum, vincristine, and peplomycin. Cis-platinum was given at a dose of 60 mg/m2 on day 1, and 1.0 mg/m2 of vincristine was given on day 3, followed 6 hours later by peplomycin 10 mg/day by continuous infusion iv or sc over the next 5 days. This combination was given every 3 weeks. The overall response rate was 71% for 17 evaluable patients, including one complete response. The median duration of response and survival was 2 and 5 months, respectively. Six other patients with esophageal and cervical carcinoma were treated with two cycles of this combination followed by radical radiation therapy or surgery. Five of them achieved significant response prior to radical treatment. Major side effects were nausea, vomiting, alopecia, and mild myelotoxicity, which were acceptable. This regimen, with a high response rate and acceptable toxicity, warrants further investigation.

Topics: Adult; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Drug Evaluation; Esophageal Neoplasms; Female; Head and Neck Neoplasms; Humans; Lung Neoplasms; Neoplasm Recurrence, Local; Peplomycin; Time Factors; Uterine Cervical Neoplasms; Vincristine

The effectiveness of combined CDDP chemotherapy with other anticancer drugs in patients with head and neck carcinoma was investigated. The response rate for COP therapy (CDDP, Vincristine, Peplomycin) was better than those for CDDP administration only or CP (CDDP Peplomycin) therapy for carcinomas of the head and neck. Forty-seven cases treated with COP therapy, were analyzed in detail. (1) Non-treated fresh cases showed a better response than recurrent cases. In other words, the induction chemotherapy is useful. (2) The grade of differentiation of squamous cell carcinoma had no correlation with the response. (3) No relationship between the primary site and the respose rate was detected. (4) Nephrotoxicity was considered to be the dose-limiting factor of CDDP therapy. COP therapy did not show any remarkable side effects. COP chemotherapy is therefore concluded to be effective for the treatment of squamous cell carcinomas of the head and neck.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Drug Administration Schedule; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Peplomycin; Vincristine

Multi-drug combination therapy with CDDP, 5-FU and PEP was performed in 23 patients with malignant tumors in the head and neck region, and 2 CR patients and 9 PR patients were obtained with a response rate of 47.8%. The present therapy (CFP therapy) is considered to be especially effective against patients at low performance status grades with poorly differentiated squamous cell carcinoma which is located in regions receiving an abundant blood supply like the oral cavity. It is advisable to perform more than 2 courses of treatment as an induction chemotherapy. With respect to the method of administration of PEP, further study will be made in the future.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Female; Fluorouracil; Head and Neck Neoplasms; Humans; Male; Middle Aged; Peplomycin; Rhabdomyosarcoma

Ninety-three patients with head and neck cancer were treated with combined cisplatin-peplomycin chemotherapy (CP therapy). Cisplatin (CDDP) 50 mg/m2 i.v. (intravenous) or i.a. (intraarterial) over 2 hr was given with hydration and mannitol diuresis on day 1. From day 2 through day 6, peplomycin (PEP) 5 mg/day was administered by 5-hr i.v. or i.a. infusion, or 24-hr continuous hypodermic injection. Of 85 who were evaluable, there were 22 complete responses or CR (26%) and 36 partial responses or PR (42%), with an overall response rate of 68%. Concerning of the route of administration, i.a. infusion obtained the higher CR and overall response rates than i.v. infusion. Effectiveness was clearly greater in previously untreated cases than in cases that had received some previous therapeutic modality. Looking at response in relation to the number of the courses, at least 2 courses of CP therapy are required. Side effects were recognized in 68 out of 87 evaluable cases (78%). Nausea and vomiting were the most common (62%). Renal toxicity was observed in 24% and was mostly transient. From the above results, it is considered that the CP therapy is effective, not only for the palliative treatment of advanced and recurrent cancer of the head and neck, but also as neo-adjuvant chemotherapy of stage III and IV cases.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Peplomycin

Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Ehrlich Tumor; Carcinoma, Squamous Cell; Cisplatin; Drug Synergism; Head and Neck Neoplasms; Mice; Mice, Nude; Neoplasm Transplantation; Peplomycin

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Peplomycin

Twenty-one patients with advanced or recurrent squamous cell carcinoma of the head and neck were treated with cisplatin, methotrexate and continuous subcutaneous infusion of peplomycin. The overall response rate was 62% (13/21) with 19% (4/21) complete response. The median duration of partial response was 2 months, while that of complete response was 3 months. Toxic effects were acceptable with no fatalities, but nephrotoxicity (33%), leukocytopenia (24%), thrombocytopenia (29%) and severe nausea and vomiting (76%) occurred. Pulmonary toxicity due to continuous subcutaneous infusion of peplomycin (15 mg/day, 4 days) was not seen.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Drug Administration Schedule; Female; Head and Neck Neoplasms; Humans; Male; Methotrexate; Middle Aged; Peplomycin

The authors have studied preoperative chemotherapy for head and neck cancer since 1963, focusing on intra-arterial chemotherapy. The results obtained revealed that preoperative chemotherapy played an important role in the improvement of 5-year survival in maxillary sinus carcinoma and tongue carcinoma. However, functional and cosmetic damage after radical surgery has newly energed as problems to be resolved. The appearance of cisplatin has raised an important the level of effectiveness of cancer chemotherapy in recent years. Since the combination of cisplatin and bleomycin analogs revealed a remarkable synergistic effect in experimental chemotherapy, it has been used clinically as preoperative or preradiation chemotherapy for advanced Stage III and IV head and neck cancer. Under the above-mentioned circumstances, treatment for head and neck cancer has undergone various changes over the past twenty years. At present it is no exaggeration to say that the period in which dependence was placed on only surgery and/or radiation is over. The authors would like to emphasize that preoperative chemotherapy should be carried out as a part of multidisciplinary approach under a new concept of neo-adjuvant chemotherapy which includes not only preoperative chemotherapy but also preradiation chemotherapy. The role of preoperative chemotherapy, its current status and future prospects are discussed in this paper, looking back on the history of chemotherapy for head and neck cancer.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Fluorouracil; Head and Neck Neoplasms; Humans; Infusions, Intra-Arterial; Maxillary Neoplasms; Mouth Neoplasms; Peplomycin; Pharyngeal Neoplasms; Preoperative Care; Tegafur; Uracil

Topics: Antibiotics, Antineoplastic; Bleomycin; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Kinetics; Maxillary Neoplasms; Peplomycin; Tongue Neoplasms

A neo-adjuvant chemotherapy as a preoperative and preradiation chemotherapy was studied in 60 cases of the head and neck cancers. Out of 60, 29 cases were treated with peplomycin (PEP) and 31 with combination chemotherapies which include vincristine (VCR), methotrexate (MTX), bleomycin (BLM), mitomycin C (MMC); VCR, MTX, BLM (Mathé); VCR, MTX, BLM, 5-FU, hydrocortisone (Price-Hill A); hydoxyurea, adriamycin, BLM; VCR, MTX, PEP; cisplatin (CPDD), PEP. In the group treated with PEP, CR was achieved in one case and PR in 14 cases with a response rate of 52%. Five-year survival by Kaplan-Meier's method after all treatment was 34%. In the group treated with combination chemotherapy, CR was achieved in 5 cases and PR in 19 cases with a response rate of 77%. Three-year survival of this group was 82%. Responders to PEP as well as combination chemotherapy were more often rendered disease-free after all treatment than non-responders. We concluded that two courses of VMP therapy (VCR, MTX, PEP) would be appropriate for the outpatients with advanced stage I or stage II, meanwhile two courses of CP therapy (CPDD, PEP) was inpatients with stage III or stage IV as a neo-adjuvant chemotherapy.

Topics: Adult; Aged; Antibiotics, Antineoplastic; Antineoplastic Agents; Bleomycin; Carcinoma, Squamous Cell; Drug Therapy, Combination; Female; Head and Neck Neoplasms; Humans; Male; Methotrexate; Middle Aged; Mitomycin; Mitomycins; Peplomycin; Vincristine