peplomycin and Pharyngeal-Neoplasms

Induction chemotherapy, followed by definitive treatment, was performed in patients with advanced squamous-cell carcinoma of the head and neck. In this study, carried out between 1984 and 1991, testing the effectiveness of multimodality therapy in patients with previously untreated advanced (stage III and IV) squamous-cell carcinoma of the pharynx, patients received two different induction chemotherapy regimens: cisplatin, vincristine (Oncovin) plus peplomycin (COP), and cisplatin plus continuous 120-hr 5-fluorouracil (5-FU) infusion (CF) for two courses. Overall response rates (complete response plus partial response) to each of the two induction chemotherapy regimens were high: 76 and 82%, respectively. Superior complete response rate in the group receiving CF therapy was 16% versus 10% for COP therapy. Responders to induction chemotherapy had significantly better survival compared with non-responders. The toxicity of these two regimens was tolerable and manageable. It is indispensable to develop the more efficacious chemotherapy regimen with the potential to induce complete disappearance of tumors in patients with advanced head and neck carcinomas.

Topics: Adolescent; Adult; Aged; Carcinoma, Squamous Cell; Cisplatin; Female; Fluorouracil; Humans; Infusions, Intravenous; Male; Middle Aged; Neoplasm Staging; Peplomycin; Pharyngeal Neoplasms; Pharynx; Retrospective Studies; Treatment Outcome; Vincristine

This report concerns a 64-year-old male suffering from advanced hypopharyngeal cancer. This patient was treated with four courses of combination chemotherapy including VPCP (a combination of VCR, PEP, CDDP and PEP) regimen as neo-adjuvant chemotherapy. And radiotherapy was given as a secondary treatment; Linac. 60 Gy/6 weeks. He showed no tumor masses in the hypopharynx following this combination chemotherapy. No recurrence has been found under endoscopy for one year after the treatment with combination chemotherapy. It thus seems that neo-adjuvant chemotherapy prior to surgery and/or radiation including cisplatin, peplomycin and other agents is very useful as a multimodal treatment for cancer of the hypopharynx.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Humans; Hypopharyngeal Neoplasms; Male; Middle Aged; Peplomycin; Pharyngeal Neoplasms; Remission Induction; Vincristine

Neo-adjuvant chemotherapy, followed by definitive surgery and/or radiotherapy was utilized in nine patients with carcinoma of the hypopharynx and cervical esophagus starting in December, 1983. They were treated with combination chemotherapies which included CDDP, PEP (BLM), and MTX. The patients' ages ranged from 52 to 70 years with an average of 57. The histologic types were all squamous cell carcinoma and performance status was 1 in all cases. There were 7 stage III and 2 stage IV. Of 9 patients, 3 showed complete response and 6 showed partial response of the primary tumor with an overall response rate of 100%. Of 8 patients, 3 showed complete response and 2 showed partial response of the metastatic node with an overall response rate of 62.5%. Toxic effects included alopecia in 9 patients, nausea/vomiting in 7, eczema in 4, RBC below 350 X 10(4)/mm3 in 5, WBC below 3000/mm3 in 1, peak serum creatinine above 2 mg/dl in 1. All patients except one with renal toxicity were able to start definitive treatment soon after chemotherapy, the primary and regional lesions being subsequently well controlled in all 9 patients. Neo-adjuvant chemotherapy appears to be very effective for the reduction of tumor bulk. This multidisciplinary therapy should be expected to increase survival rate.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Drug Administration Schedule; Esophageal Neoplasms; Female; Humans; Hypopharyngeal Neoplasms; Lymphatic Metastasis; Male; Methotrexate; Middle Aged; Peplomycin; Pharyngeal Neoplasms

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

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