peplomycin and Maxillary-Neoplasms

Pharmacologic effects of cisplatin (CDDP) and peplomycin (PEP) on tumor cell kinetics were studied both in vitro and in vivo with the aid of flow cytometry (FCM). Double staining with propidium iodide (PI) and fluorescein isothiocyanate (FITC)-labeled bromodeoxyuridine (BrdU) was used to analyze the cell cycle, and the number of viable cells was determined with fluorescein diacetate (FDA). Effects of combining the 2 agents were also studied to establish the most effective method of combination therapy. Furthermore, these agents were tried clinically on the basis of experimental results. Results showed that CDDP exerted its action at the S and G2M phases in the cell cycle and PEP at the G2M phase. Among the combination regimens in the experiments with CDDP, PEP, and CDDP + PEP as analyzed by FCM, the strongest block on the G2M phase was shown in the one at a 2-day interval, resulting in the most effective killing of the tumor cells. Clinical trial of the combination therapy showed the same results as the in vitro experiment; the therapy proved useful for improving the patient's clinical condition and the results obtained with CT imaging and pathology.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Bromodeoxyuridine; Carcinoma, Squamous Cell; Cell Cycle; Cisplatin; Flow Cytometry; G2 Phase; Humans; In Vitro Techniques; Male; Maxillary Neoplasms; Middle Aged; Peplomycin; S Phase; Tumor Cells, Cultured

A case of advanced maxillary ameloblastoma was successfully treated with combined intra-arterial chemotherapy (Peplomycin, 85 mg) and radiotherapy (Co60, 7080 r). The tumour showed a remarkable shrinkage, and the patient survived. He is still alive and well at the time of this report. Carefully applied chemotherapy combined with radiotherapy has a useful role in the management of ameloblastoma especially in an advanced maxillary tumour. This report presents a typical example, which indicates that the ameloblastoma may not be an inherently radioresistant and chemoresistant tumour.

Topics: Ameloblastoma; Antibiotics, Antineoplastic; Bleomycin; Cobalt Radioisotopes; Combined Modality Therapy; Humans; Injections, Intra-Arterial; Male; Maxillary Neoplasms; Middle Aged; Neoplasms, Second Primary; 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

Cases of maxillary cancer treated at our institute can be divided into two groups. In the first group (1971-1982, N = 85), we treated maxillary cancer by preoperative intraarterial infusion of 5-FU and Linac X-ray irradiation (60 Gy/6 weeks), followed by maxillectomy. In the second group (1982-1986, N = 32), we further combined intraarterial or intravenous chemotherapy using CDDP preoperatively or postoperatively depending upon the stage of the cancer. Five-year survival rate was 64.7% in the first group and 73.9% in the second. In the first group, the most frequent cause of death was distant metastasis without local recurrence. In the second group, the histopathological effect of chemotherapy and radiotherapy was improved with a reduced frequency of distant metastasis and it has now become possible to have 5-year survivors from among N2 and M1 cases. Judging from the histopathological effects of chemotherapy and radiotherapy, it seems possible to treat T2 and some T3 cases of maxillary cancer without performing maxillectomy. However, in T4 and most of T3 cases in which early recurrence is difficult to detect, it seems safer to combine total maxillectomy primarily.

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Female; Humans; Injections, Intra-Arterial; Lymphatic Metastasis; Male; Maxillary Neoplasms; Melanoma; Middle Aged; Peplomycin

Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Drug Synergism; Humans; Kinetics; Maxillary Neoplasms; Peplomycin

A new multidisciplinary treatment for head and neck cancer was shown by focusing on the maxillary and oropharyngeal carcinoma. Neo-adjuvant chemotherapy which consists of cisplatin and peplomycin was incorporated into it. In terms of maxillary carcinoma, 2 courses of chemotherapy were given with an interval of 2 weeks, followed by radiotherapy (40 Gy) combined with intraarterial chemotherapy (5-FU). When no cancer cells were detected at the completion of this therapy, adjuvant chemoimmunotherapy was given. When an apparent tumor was still revealed by CT, radical surgery was performed. When cancer cells were detected only by histological examination, additional radiotherapy up to 60 Gy was given by Linac. The results obtained were analysed in 14 cases. We also presented another type of multidisciplinary treatment in oropharyngeal carcinoma.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Fluorouracil; Humans; Male; Maxillary Neoplasms; Oropharyngeal Neoplasms; Peplomycin; Pharyngeal Neoplasms; Radiotherapy Dosage

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

During the period 1957-1982, 227 patients with maxillary carcinoma were treated. These cases were divided into 4 groups according to periods and methods of treatment. Five-year determinate survival figures for each group are as follows: I (1957-1966) 22%, 20/91, II (1967-1973) 40%, 27/67, III (1974-1978) 37%, 13/35, IV (1979-1982) 56%, 9/16 (3-year survival). The incorporation of intraarterial chemotherapy into the treatment of maxillary carcinoma has much contributed to an improvement of 5-year survival. Since 1982, a new multidisciplinary treatment containing neo-adjuvant chemotherapy has been introduced into the treatment of this type of carcinoma. Neo-adjuvant chemotherapy: day 1, cisplatin ( CPDD ) 50 mg/m2 or 80 mg/body i.a. over 2 hr., day 2-6, peplomycin (PEP) 5 mg/day i.a. over 5 hr. Two courses of chemotherapy were given with an interval of 2 weeks. Radiotherapy combined with intraarterial chemotherapy: Linac. 40 Gy/4 wks., 5-FU i.a. 250 mg/day q.d. (for 10 days). When no cancer cells were detected at the completion of this therapy, adjuvant chemoimmunotherapy was given. When an apparent tumor was still revealed by CT, radical surgery was performed. When cancer cells were detected only by histological examination, additional radiotherapy up to 60 Gy was given by Linac. The results obtained were analysed in 9 patients who completed this therapy. At the completion of CPDD and PEP treatment, complete response was achieved in 5 cases and partial response in 3 cases with a response rate of 89%. In 2 out of the 9 cases, no cancer cells were detected by histological examination after chemotherapy. No cancer cells were detected in 2 other cases after 40 Gy by Linac. combined with 5-FU i.a. infusion, and in 3 other cases after 60 Gy by Linac. combined with 5-FU. Two patients had radical surgery because of uncontrolled tumors. Periods of follow-up are too short, but it is expected that this new multidisciplinary treatment results in the higher survival.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Drug Combinations; Fluorouracil; Humans; Male; Maxillary Neoplasms; Middle Aged; Peplomycin; Tegafur; Uracil

Two cases of fatal pneumonitis induced by pepleomycin, a new antitumour antibiotic analogous to bleomycin, are described. In the first case, the patient received radiation in combination with intra-arterial administration of pepleomycin to a total dose of 100 mg. for the treatment of an epidermoid carcinoma of the maxilla. The pulmonary changes were noted two weeks after cessation of the chemotherapy and the patient died of pulmonary insufficiency despite intensive therapy with antibiotics and a steroid. The other case with an epidermoid carcinoma of the cheek and oropharynx was treated by radiation and pepleomycin given to a total dose of 205 mg. Pepleomycin was replaced by predonin soon after bilateral shadows were noticed on a chest radiograph, but the patient died of pneumonitis 10 months later. Various factors which may affect the development of pulmonary toxicity by pepleomycin are discussed.

Topics: Aged; Antibiotics, Antineoplastic; Bleomycin; Carcinoma, Squamous Cell; Female; Humans; Male; Maxillary Neoplasms; Middle Aged; Mouth Neoplasms; Peplomycin; Pharyngeal Neoplasms; Pneumonia

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