peplomycin and Urinary-Bladder-Neoplasms

We performed a study to compare the usefulness of double or single anticancer agents in the prophylactic treatment after the transurethral resection (TUR) of superficial bladder cancer. We experienced 127 superficial bladder cancer cases. Of these cases, 42 were treated with intravesical adriamycin (ADR) and peplomycin (PEP), 56 with ADR, PEP, epirubicin (epi-ADR) or pirarubicin (THP) only, and the remaining 29 with TUR only. Nonrecurrence rates were significantly higher in the intravesical treated cases than in the cases with TUR only, and also significantly higher in the cases treated with ADR and PEP than the other treated cases. We concluded that intravesical chemotherapy with combined agents was more effective than with a single agent.

Topics: Administration, Intravesical; Aged; Antibiotics, Antineoplastic; Doxorubicin; Drug Therapy, Combination; Female; Humans; Male; Neoplasm Recurrence, Local; Peplomycin; Urinary Bladder Neoplasms

We have developed a new combination intravenous chemotherapy regimen called COMPA (IV-COMPA). The clinical value of IV-COMPA chemotherapy was evaluated based on the results of 24 patients with urothelial cancers. From October 1989 through October 1993, a total of 24 patients (20 males and 4 females) received IV-COMPA chemotherapy at Tokyo Medical College Hospital and Tokyo Medical College Hachioji Medical Center. All patients had advanced transitional cell carcinoma or adenocarcinoma of the urothelial tract (renal pelvis, ureter or bladder). One course of IV-COMPA was delivered at 2-week intervals and consisted of 30 mg/m2 CDDP on day 4 and 5, 0.6 mg/m2 VCR (Oncovin) on day 1 and 2, 5 mg/m2 MTX on day 2 and 3, 5 mg/m2 PEP on day 1, 2 and 3, 20 mg/m2 ADM on day 4. A few patients received the same regimen without peplomycin called IV-COMA to avoid pulmonary fibrosis. Fifteen patients with surgically confirmed invasive carcinoma were defined by at least 1 of the following criteria: multiple tumors or size greater than 5 cm, grade 3, stage P3 or P4, pN+, pR1, pL1, pV1, or secondary carcinoma in situ. These patients were treated with 2 or 3 corpses of postoperative IV-COMPA chemotherapy to improve prognosis. In this group, 14 of 15 (93%) are alive at a median follow-up of 22 months (range, 8-57 months) and actuarial survival rates of 1 and 3 years were 100%, 90.9%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Transitional Cell; Cisplatin; Doxorubicin; Drug Administration Schedule; Female; Humans; Infusions, Intravenous; Injections, Intramuscular; Kidney Neoplasms; Kidney Pelvis; Male; Methotrexate; Middle Aged; Peplomycin; Urinary Bladder Neoplasms; Vincristine

Patients with superficial transitional cell cancer of the urinary bladder were entered into a randomized trial to compare the effects of immediate and short-term postoperative instillation of peplomycin sulfate with simple irrigation. Although the recurrence-free rate of the 46 peplomycin-treated patients was lower, the difference was not significant. Repeated washing of the bladder at the end of transurethral resection might partly replace the role of cytotoxic therapy.

Topics: Administration, Intravesical; Aged; Carcinoma, Transitional Cell; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Neoplasm Staging; Peplomycin; Recurrence; Therapeutic Irrigation; Time Factors; Tumor Cells, Cultured; Urinary Bladder Neoplasms

The present investigation was conducted to examine the effect of neoadjuvant PVB and CAP regimens for locally invasive bladder cancer and consisted of two studies: (1) a retrospective nonrandomized study of neoadjuvant PVB therapy, and (2) a well-controlled randomized study of neoadjuvant CAP therapy. A total of 25 patients with primary locally invasive bladder cancer were entered into the PVB study between January 1981 and December 1985. Since 1986, 31 patients have been randomized into the CAP study. In the PVB-treated group, a 71.4% complete response (CR) plus partial response (PR) rate and a 71.4% downstaging were noted. On the other hand, in the CAP-treated group, a 50.0% CR plus PR rate and a 88.9% downstaging were noted. The 2- and 5-year survival rates of neoadjuvant PVB were 78.6 and 60.6%, respectively. In contrast, the 2-year survival rate of the neoadjuvant CAP-treated group was 100% at a mean follow-up of 15.8 months. No statistical significance was achieved in the survival rates. These results indicated that neoadjuvant PVB and CAP would be useful in the management of invasive bladder cancer.

Topics: Aclarubicin; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Transitional Cell; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Neoplasm Invasiveness; Peplomycin; Randomized Controlled Trials as Topic; Retrospective Studies; Survival Analysis; Urinary Bladder Neoplasms; Vinblastine

Two kinds of clinical studies for intravesical instillation chemotherapy of peplomycin (PEP) were carried out, one to evaluate the direct antitumor activity in superficial bladder cancer (study I), and the other to evaluate the prophylactic effect on recurrence of bladder cancer after transurethral resection (study II). In study I, 22 patients with low stage bladder cancer were entered, and 16 of them were eligible for evaluation of efficacy. Twelve patients were treated twice a week with intravesical instillation of 20 mg of PEP/20 ml of saline for 4 weeks. Four patients were treated in the same way with 40 mg of PEP/20 ml of saline. Among the patients treated with 20 mg of PEP, two showed complete remission and one showed partial remission. Of the patients treated with 40 mg of PEP, one showed partial remission. Thus, the overall response rate was 25%. The tumors of the two complete responders were so tiny that they might have been damaged mechanically by the biopsy forceps. Therefore, we considered that the instillation chemotherapy of PEP at a dose of 20 or 40 mg/20 ml of saline had little effect on superficial bladder cancer. In study II, we performed a randomized trial designed to compare the recurrence rate after transurethral resection (TUR) alone with that after TUR followed by prophylactic instillation of PEP. Ninety-four patients newly diagnosed as having low stage bladder cancer were entered in the study. They were divided into three groups after TUR. Group A consisted of 38 patients who were treated with weekly instillation of 20 mg of PEP/20 ml of saline for 8 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Intravesical; Adult; Aged; Aged, 80 and over; Bleomycin; Carcinoma, Transitional Cell; Combined Modality Therapy; Drug Evaluation; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Peplomycin; Random Allocation; Remission Induction; Urinary Bladder Neoplasms

To evaluate the effects of bladder instillation chemotherapy of anticancer agents with OK-432 intradermal injection (group A) in preventing postoperative recurrence of bladder carcinoma, a randomized controlled study with intravesical instillation chemotherapy of anticancer agents (group B) as the reference standard was performed. As the anticancer agents, pepleomycin (PEP) was usually used at a concentration of 30 mg/30 ml physiological saline. OK-432 injection dose was gradually increased from 0.5 KE to 5.0 KE and maintenance dose was decided by local skin reactions. There were no differences in the patient's background factors between group A (22 cases) and group B (17 cases). The no-recurrence rate of bladder carcinoma was similar in the two groups, but the no-recurrence rate for the virgin tumor or the stage T0 cases was higher in group B. On the other hand, the values for the recurrent cases or the stage T1,2 cases was higher in group A. The SU-PS skin reaction as an immunological response was significantly higher in group A. There were no severe side effects derived from anticancer bladder instillation or OK-432 injection.

Topics: Administration, Intravesical; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Biological Products; Bleomycin; Female; Humans; Injections, Intradermal; Male; Middle Aged; Multicenter Studies as Topic; Neoplasm Recurrence, Local; Neoplasm Staging; Peplomycin; Picibanil; Postoperative Complications; Random Allocation; Urinary Bladder Neoplasms

Topics: Adult; Aged; Bleomycin; Clinical Trials as Topic; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Peplomycin; Prostatic Neoplasms; Suppositories; Urinary Bladder Neoplasms

Patients with muscle-invasive bladder cancer (MIBC) often undergo various preoperative treatments to improve survival; however, their efficacy and safety remain unclear.. The anti-tumour effects and adverse events were evaluated in 163 MIBC patients who received systemic chemotherapy (SC, n = 34), intra-arterial chemotherapy (IAC, n = 50), or combined IAC and radiotherapy (IAC + R, n = 79).. Pathological complete responses were observed in 17.6%, 22.0%, and 43.0% of patients in the SC, IAC, and IAC + R groups, respectively, with respective 5-year overall survival rates of 42.0%, 46.7%, and 50.3%. Multivariate analysis showed that successful IAC + R protocol administration was a significant predictor for survival (hazard ratio = 0.16, p = 0.028). The incidence of severe adverse events was higher in the IAC + R group (36.7%) than in the SC (9.8%) and IAC groups (16.0%).. IAC + R was useful for patients with MIBC. Successful completion and optimal patient selection were important for this treatment strategy.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma, Transitional Cell; Chemoradiotherapy; Chemoradiotherapy, Adjuvant; Chemotherapy, Adjuvant; Cisplatin; Cystectomy; Female; Fluorouracil; Humans; Infusions, Intra-Arterial; Male; Middle Aged; Multivariate Analysis; Neoadjuvant Therapy; Neoplasm Invasiveness; Organ Sparing Treatments; Peplomycin; Prognosis; Treatment Outcome; Urinary Bladder; Urinary Bladder Neoplasms

We report a case of regionally metastatic pure squamous cell carcinoma of the urinary bladder successfully treated with combined radiation and chemotherapy in a 46-year-old man. Clinical staging was T3bN2M0. The patient received 50 Gy external radiation combined with intraarterial and systemic chemotherapy. Pathological complete response was found both in bladder and regional lymph nodes when he underwent radical cystectomy and lymph node dissection. The patient has been alive without evidence of disease for two years postoperatively.

Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Doxorubicin; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Peplomycin; Radiotherapy Dosage; Urinary Bladder Neoplasms

We investigated the clinical usefulness of individualization of chemotherapeutic regimen in neoadjuvant intra-arterial chemotherapy for locally invasive bladder cancer. Anticancer drugs were selected according to the results of an in vitro chemosensitivity test (collagen matrix assay or succinic dehydrogenase inhibition test). Nine patients with locally invasive bladder cancer received 1 to 4 courses of neoadjuvant intra-arterial chemotherapy, followed by radical cystectomy. Histopathological responses in the cystectomized specimens were grade 3 in 3 cases, grade 2 in 2, grade 1b in 2 and no response in 2. Pathologically, a complete response and downstaging were observed in 3 and 4 cases, respectively. Seven of the 9 patients were alive no evidence of disease with a mean follow-up period of 38.9 months, whereas 2 patients died of metastasis within 2 years. Six of the 7 patients who showed a complete response or down staging have been free of recurrence. These findings suggest that our chemotherapeutic strategy may improve the prognosis for locally invasive bladder cancer.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Cisplatin; Doxorubicin; Drug Administration Schedule; Drug Screening Assays, Antitumor; Epirubicin; Etoposide; Female; Fluorouracil; Humans; Infusions, Intra-Arterial; Male; Middle Aged; Mitomycin; Peplomycin; Prognosis; Tumor Cells, Cultured; Urinary Bladder Neoplasms; Vinblastine

(BACKGROUND). The object of this study is to evaluate the efficacy of preoperative chemotherapy combined with radiation therapy for bladder cancer. (METHOD). A total of 44 patients with bladder cancer were treated by preoperative chemotherapy combined with radiation therapy between October, 1981 and December, 1986. Of the 44 patients, ranging in age from 40 to 82, with an average age of 65.8, 34 were male and 10 were female. Clinical stages included 4 patients in Ta, 25 in T1, 11 in T2, and 4 in T3. Each patient was treated twice with 15 gray of radiation to the small pelvic cavity and a chemotherapy combination of adriamycin, cis-platinum, tegaful, and peplomycin. The average observation time after the therapy was 83 month, with the maximum being 146 months. (RESULTS). Complete remission was included in 5 patients, partial remission in 27, and no change in 12. Thus, the overall effective rate was 72.8%. Operations, selected by the results of the preoperative therapy, included transurethral resection on 28 patients, transurethral fulguration on 2, partial cystectomy on 4, resection of tumor on 4, and total cystectomy on 3. Operations were not performed on 2 patients and not allowed on 1 patient. The outcome during the long-term follow-up included cancer related deaths in 4 patients, and death resulting from other disorders in 9. The 5-year survival rates for superficial and invasive bladder cancer were 92.4%, and 83.9%, respectively. The 10-year survival rates for superficial and invasive bladder cancer were also 92.4% and 83.9%, respectively. The 3-year and 5-year non-recurrence rates for superficial bladder cancer were 75.8%, and 66.9% respectively, according to the Kaplan-Meier method. On the other hand, the 3-year and 5-year non-recurrence rates for invasive bladder cancer were both 73.8%. During the follow-up between 9 and 11 years, 3 upper tract tumor were diagnosed (2 ureteral cancer, and 1 renal pelvic cancer). (CONCLUSION). We concluded that preoperative chemotherapy combined with radiation therapy may be effective for the treatment of bladder cancer.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Doxorubicin; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Peplomycin; Preoperative Care; Survival Rate; Tegafur; Treatment Outcome; Urinary Bladder Neoplasms

Thirty-three patients with malignant bladder tumours were treated by hyperthermic intravesical perfusion. The study group included 25 patients with superficial T1 bladder tumours, 4 with T2 tumours and 4 with T3 tumours. Physiological saline solution containing 40 micrograms/ml peplomycin with/without 2% ethanol was used as a perfusate. Perfusion was carried out for 2 h 3 times per week and this regimen was repeated every other week, totalling 6 sessions in 3 weeks. Three patients achieved a complete response (CR), 5 a partial response (PR) (more than 50% tumour reduction), 8 a minimal response (MR) (25-50% tumour reduction) and the remaining 17 patients showed no response (NC). Complete, partial and minimal responses were obtained only in patients with T1 tumours. The NC patients included 4 with T2 and 4 with T3 lesions. Profuse haematuria from invasive tumour was markedly reduced after treatment. A major side effect was irritation of the bladder and urethra. Our results indicate that hyperthermic perfusion with ethanol and peplomycin is clinically safe, is accompanied by very little pain and may be useful for the management of superficial bladder tumours in elderly patients.

Topics: Aged; Aged, 80 and over; Chemotherapy, Cancer, Regional Perfusion; Female; Humans; Hyperthermia, Induced; Male; Middle Aged; Peplomycin; Urinary Bladder Neoplasms

We presented 12 patients with invasive bladder cancer treated by the subselective intra-arterial COMPA chemotherapy. COMPA was administered up to an average of 3.3 courses (ranged from 2 to 6 courses) every 2 or 3 weeks, consisting of cisplatin: 15 mg/M2 on days 4 and 5; vincristine (oncovin): 0.6 mg/M2 on days 1 and 2; methotrexate: 5 mg/M2 on days 2 and 3; peplomycin: 5 mg/body on days 1, 2 and 3; and adriamycin: 10 mg/M2 on day 4. These were injected through a teflon catheter the tip of which was placed just proximal to the aortic bifurcation, and another tip was led through a subcutaneous tunnel from the inguinally punctured area to the anterior chest wall. The 12 patients, 7 men and 5 women, ranged in age from 53 to 73 (mean: 67) years. Histopathologically 11 had transitional cell carcinoma and one had adenocarcinoma. Malignant gradings were grade 2 in 8 patients, and grade 3 in 4. The stagings were T2 in 3 patients, T3 in 5, T4 in 4 and only one had bony metastasis. Of the 12 patients, 10 were alive at the last follow-up with a mean duration of 36 months (range: 16 to 49). Six patients achieved a complete remission, four achieved a partial remission and two were stable. One died of ileus after 16 months and another of progression after 36 months. All the patients received post-chemotherapeutic adjunctive therapies, which were transurethral resection, partial cystectomy, radiation and/or intravesical instillation. The toxicities were not severe, but anorexia, nausea, vomiting, hair loss, numbness of fingers and/or toes, subileus, and leukopenia were noticed.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Transitional Cell; Cisplatin; Doxorubicin; Drug Administration Schedule; Female; Humans; Infusion Pumps, Implantable; Infusions, Intra-Arterial; Male; Methotrexate; Middle Aged; Peplomycin; Remission Induction; Urinary Bladder Neoplasms; Vincristine

Seventeen patients with bladder cancer were treated with semiselective intraarterial COMPA chemotherapy. One course of COMPA consisted of 20 mg/m2 cis-diammine-dichloroplatinum (CDDP) on days 4 and 5, 0.6 mg/m2 vincristine (VCR) (Oncovin) on days 1 and 2, 5 mg/m2 methotrexate (MTX) on days 2 and 3, 5 mg/body peplomycin (PEP) on days 1, 2 and 3, and 15 mg/m2 adriamycin (ADM) on day 4. These drugs were injected every 2 or 3 weeks through a polyurethane catheter the tip of which was placed just proximal to the aortic bifurcation and during injection both thighs were tied with a pressure of over 250 mmHg. From 2 to 6 courses (mean, 4.4 courses) were administered. Of the 17 patients, 4 achieved complete remission, 10 achieved partial remission and 3 showed no change. After this COMPA chemotherapy eight patients were able to retain their bladders while seven underwent immediate radical cystectomy. The adjuvant COMPA chemotherapy for two patients with pelvic metastasis after radical cystectomy showed good results. Mild degrees of anorexia, nausea, vomiting, hair loss, numbness of fingers and/or toes, leukopenia and intestinal paralysis were observed. Instrumental troubles were seen in two cases; one involved dislocation of the tip of the catheter, the other was infection of the reservoir. Intraarterial COMPA chemotherapy is effective for neoadjuvant therapy of invasive bladder cancer, bladder-preserving treatment and adjuvant therapy of pelvic metastasis.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Cisplatin; Doxorubicin; Drug Administration Schedule; Female; Humans; Infusions, Intra-Arterial; Male; Methotrexate; Middle Aged; Peplomycin; Urinary Bladder Neoplasms; Vincristine

Peplomycin emulsified in hydroxypropyl cellulosum (HPC-PEP) was prepared for intravesical chemotherapy. Clinical efficacy of HPC-PEP and tissue concentration of peplomycin (PEP) were studied in 12 patients with bladder tumor. Histopathology showed transitional cell carcinoma; 2 in grade 1,8 in grade 2, and 2 in grade 3. The total volume of 30 ml HPC-PEP was prepared from a mixture of 2% HPC and 90 mg PEP in 15 ml saline, and was intravesically administered through a urethral catheter and retained for two hours. Clinical evaluation 7 days after the initial instillation demonstrated good tumor regression in 2, good response in 5, and no change in 5. The mean PEP level in tumor tissue was 0.36 microgram/gr after 7 days and 0.19 microgram/gr even after 14 days. These clinical observations and tissue levels of PEP suggest that HPC-PEP might be useful as an intravesical instillation agent for bladder tumor.

Topics: Administration, Intravesical; Adult; Aged; Bleomycin; Carcinoma, Transitional Cell; Cellulose; Delayed-Action Preparations; Emulsions; Female; Humans; Male; Middle Aged; Peplomycin; Urinary Bladder; Urinary Bladder Neoplasms

A case of invasive pure squamous cell carcinoma of the urinary bladder effectively responsive to combination chemotherapy in a 79-year-old female is reported. Clinical staging of the tumor was T3b. We used combination chemotherapy with methotrexate, peplomycin and cis-platinum (MBD regimen) before radical cystectomy. Remarkable regression of the tumor was identified by computed tomographic scan after one course of chemotherapy and the surgical specimen revealed no viable tumors. The patient has been very active in her daily life without evidence of local recurrence or metastasis for more than one year. Squamous cell carcinoma of the bladder generally is regarded as having a poor prognosis with 5-year survival rates ranging from 7.4 to 26% and effective chemotherapy has not yet been established. Our experience suggests that the cure rate of pure squamous cell carcinoma may be improved markedly by the use of MBD regimen.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Cystectomy; Female; Humans; Methotrexate; Peplomycin; Remission Induction; Urinary Bladder Neoplasms

Selective intra-arterial infusion of ethylcellulose microcapsules containing anticancer drug exerts its therapeutic effects through infarction and sustained drug action (i.e., chemoembolization). Seven hundred and fifty-nine patients with malignant tumors of the liver (310), kidney (177), bladder (100), prostate (41), lung (39), pelvic organs (13), bone (4) and other (75) were treated with single or repeated chemoembolization using microcapsules delivered through percutaneous catheterization as a preoperative or palliative measure. Substantial tumor reduction of 50% was found in 18% of hepatoma, 19% renal cell carcinoma, 54% bladder carcinoma and 54% prostate carcinoma cases. Preoperative chemoembolization facilitated radical surgery for various cancers and significantly improved the survival of patients with locally invasive renal cell carcinoma and bladder carcinoma. Systemic toxic effects were mild, and all patients tolerated the treatment except for one who died of remote embolism to spleen and gallbladder. These results suggested that microcapsule chemoembolization can be successfully applied to a variety of tumors with low morbidity and mortality, and also combined with other treatments in multidisciplinary therapy.

Topics: Adolescent; Adult; Bleomycin; Capsules; Carcinoma, Hepatocellular; Carcinoma, Renal Cell; Cisplatin; Embolization, Therapeutic; Female; Humans; Kidney Neoplasms; Liver Neoplasms; Male; Middle Aged; Peplomycin; Prognosis; Prostatic Neoplasms; Urinary Bladder Neoplasms

The effect of intravesical combination chemotherapy on superficial bladder tumors was analyzed. Seventy-two patients were treated with intravesical instillation of the following anticancer drugs. MMC group: Mitomycin C (MMC) 10 mg and cytosine arabinoside (CA) 300 mg. ADM group: Adriamycin (ADM) 30 mg and CA 300 mg. PEP group: Peplomycin (PEP) 30 mg and CA 300 mg. MAC group: MMC 10 mg, ADM 30 mg and CA 300 mg. Antitumor effects in the MMC, ADM, PEP and MAC groups were evaluated in 16, 18, 17 and 21 patients and objective response (CR + PR) of tumor was observed in 87.5%, 50.0%, 35.3% and 28.6% of these patients. The papillary tumors, small tumors and low grade tumors responded better to these intravesical chemotherapies than the non-papillary tumors, the middle grade tumors and the high grade tumors. The recurrence rate in 72 patients was 6.9, 14.6 and 26.8% within 1, 2 and 3 years. No significant difference in the recurrence rate was observed between the MMC, ADM, PEP and MAC group, but the MMC group tended to have a lower recurrence rate than the other groups. The recurrence rate for the low grade tumors and the middle grade tumors was significantly lower than that for the high grade tumors and the small tumors. The major side effect of instillation therapy with these drugs was bladder irritation which appeared in 16.7% of all the patients (78 cases). In conclusion, intravesical chemotherapy is a useful approach for controlling superficial urinary bladder tumors, especially the combination of MMC and CA.

Topics: Administration, Intravesical; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cytarabine; Doxorubicin; Female; Humans; Male; Middle Aged; Mitomycin; Mitomycins; Peplomycin; Urinary Bladder Neoplasms

Clinical efficacy of a new preparation of peplomycin emulsion in hydroxypropylcellulosum (HPC-PEP) was studied in 26 patients to compared with that in 14 patients administered with 60 mg of PEP in 20 ml saline (S-PEP). The HPC-PEP was a mixture of 90 mg PEP suspended in 30 ml of 1% HPC. Both of preparations were retained in the bladder cavity over an hour after the instillation. Intravesical instillation was performed once for the patients with HPC-PEP, and 10 times repeatedly for the patients with S-PEP. A clinical evaluation was made on the basis of cytoscopic finding and cytology one week after the final instillation. According to the degree of tumor reduction, the results were classified into "disappearance", "greater than 50% reduction," and "no alteration or further growth" of primary tumor, which were referred respectively to "complete response (CR)", "partial response (PR)" and "not changed (NC)". The rates of CR and response were 27 and 73% respectively for the HPC-PEP administered patients, which were significantly higher than those of 8 and 43% respectively for the patients with S-PEP. In terms of configuration and number of tumor, intravesical HPC-PEP treatment was found to be superior to intravesical S-PEP treatment. In HPC-PEP treatment, a series of untoward symptoms such as bladder irritability and leukopenia was encountered at a frequency of 8%, which is much less than those seen in the S-PEP treatment. These clinical date suggest that HPC-PEP treatment against the superficial bladder tumors is superior to conventional S-PEP instillation in terms of administration frequency and potent doses available to tumor reduction.

Topics: Administration, Intravesical; Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Bleomycin; Cellulose; Delayed-Action Preparations; Emulsions; Female; Humans; Male; Middle Aged; Peplomycin; Remission Induction; Sodium Chloride; Urinary Bladder Neoplasms

A new peplomycin (PEP) preparation was employed as an emulsion form in hydroxypropylcellulosum (HPC), which is familiar to have a liniment effect with a strong affinity to mucosa of the organ, in the management of 6 patients with bladder tumors. This emuled PEP in HPC (HPC-PEP) was instillated and thereafter, maintained for at least 2 hours at the frequency of once a week. All 6 patients had histopathologically confirmed T1 or T2 transitional cell carcinoma on biopsied specimen. The histological grading of the tumors were divided to 2 in G1, 3 in G2, and 1 in G3 of transitional cell carcinoma. The instillated agent was prepared from the mixture of 15 ml of 6% HPC and 90 mg PEP in 15 ml saline prior to use. A response to this treatment was evaluated primarily by cystoscopic findings and urine cytology 7 days after the instillation. In the present study, the beneficial effects of this treatment were briefly segregated into 4 categories as follows: excellent, good, fair and no responses were referred respectively to as complete eradication of visible tumor with negative urine cytology, a complete disappearance of the primary tumor with a persistent positive cytology, regression of the tumor size and no change of the primary tumor with sustained positive cytology. According to this estimation, 6 patients were categorized to 1 in excellent, 2 in good, 2 in fair and 1 in no responses to this new therapeutic preparation. Furthermore, urinary and serum levels of PEP were determined daily for 7 days after the instillation.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Intravesical; Aged; Aged, 80 and over; Bleomycin; Carcinoma, Transitional Cell; Cellulose; Emulsions; Female; Humans; Male; Peplomycin; Pharmaceutical Vehicles; Urinary Bladder Neoplasms

Rats were treated for 1 week each with 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN), 0.2% N-bis(2-hydroxypropyl)-nitrosamine (DHPN) and 0.2% N-ethyl-N-hydroxyethylnitrosamine (EHEN) in the drinking water, and then administered diet containing 5% sodium L-ascorbate (Na-AsA), 1% butylated hydroxytoluene (BHT) or 0.05% phenobarbital (PB), or weekly intraperitoneal injections of 2 mg of pepleomycin per kg body weight until week 36. Histopathological examination revealed that all exerted significant modulation effects on tumor development in the various target organs. Na-AsA was found to inhibit liver but promote renal pelvis and bladder carcinogenesis. BHT similarly decreased liver and enhanced bladder lesion development. PB, in contrast promoted hepatocarcinogenesis. However both PB and BHT were associated with increased incidences of adenomas and adenocarcinomas of the thyroid. Thus the wide-spectrum initiation model allowed confirmation of site-specific modification potential and in addition demonstrated potentiation of kidney and bladder carcinogenesis promotion by pepleomycin.

Topics: Animals; Ascorbic Acid; Bleomycin; Body Weight; Butylated Hydroxytoluene; Cocarcinogenesis; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Male; Neoplasms, Experimental; Peplomycin; Phenobarbital; Rats; Rats, Inbred F344; Thyroid Neoplasms; Urinary Bladder Neoplasms

Selective intra arterial hypertensive infusion of CDDP (100 mg) and PEP (40 mg) with angiotensin II was performed in a 64 year-old housewife with inoperable uterine cervical cancer stage IVa and transitional cell cancer of bladder (grade 1-2). PEP at 5 mg/day was also administered for 20 days (total 100 mg) using an implanted Drug Delivery System through the left internal iliac artery combined with irradiation therapy. There were hardly any side effects due to this treatment except for a slight upper digestive tract disturbance and bone marrow suppression, and the cancerous lesion gradually regressed following this treatment. This case suggested the efficacy of intra-arterial infusion using an implanted Drug Delivery System for advanced uterine cervical cancer. There has been no sign of recurrence six months after this treatment.

Topics: Angiotensin II; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Cisplatin; Combined Modality Therapy; Female; Humans; Infusion Pumps; Infusions, Intra-Arterial; Middle Aged; Neoplasms, Multiple Primary; Peplomycin; Remission Induction; Urinary Bladder Neoplasms; Uterine Cervical Neoplasms

A total of 22 patients with locally invasive transitional cell carcinoma of the urinary bladder were treated with neoadjuvant cis-diamminedichloroplatinum (CDDP), vincristine, peplomycin (PVB) or cyclophosphamide, doxorubicin, CDDP (CAP) combined with radiation therapy in our institutes between June, 1982 and May, 1988. Twelve patients were entered into the PVB regimen and the remaining 10 patients into the CAP regimen. In the PVB treated group, clinical response was obtained in 2 complete response (CR) and 6 partial response (PR), 8 out of 12 patients (66.7%). Downstaging was noted in 8 out of 12 patients (66.7%). In the CAP treated group, a clinical response was obtained in 1 of CR and in 2 of PR out of the 9 patients with evaluable lesions (33.3%). Downstaging was noted in 6 out of 9 patients (66.7%). There were no significant side effects in either the PVB or CAP treated groups, and these neoadjuvant therapies were well-tolerated. These results indicated that neoadjuvant PVB or CAP combined with radiation therapy would be useful in the management of invasive bladder cancer.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Transitional Cell; Cisplatin; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Drug Evaluation; Female; Humans; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Peplomycin; Remission Induction; Urinary Bladder Neoplasms; Vincristine

During the past 10 years, we have experienced 110 bladder tumor cases. Among them, 70 patients were diagnosed superficial bladder tumor. Of these 70 cases, 30 were treated with intravesical adriamycin (ADR) and peplomycin (PEP), 13 with ADR only and one case with PEP and remaining 26 with TUR and hydrostatic pressure technique. We studied the efficacy of combination intravesical chemotherapy with ADR and PEP and other treatments in the prevention of recurrence in the superficial bladder tumor cases. The recurrence rate during 3 years of each group, was 25% in the group treated with ADR and PEP, 35% with ADR and 55% in remaining group. 3 years recurrence rate in the group treated with ADR and PEP was significantly low than that in the group tread with TUR and hydrostatic pressure technique alone (Wilcoxon test). Side effects was pollakisuria, pain after micturition and others. Anaphylactic shock appeared in one case. From these results we concluded that intravesical chemotherapy with combined agents is more effective than that with a single one or no treatment after TUR.

Topics: Administration, Intravesical; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Doxorubicin; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Peplomycin; Urinary Bladder Neoplasms

To 62 vesical tumor patients, 30 ml of a HPC-PEP mixed solution was infused into the urinary bladder. The HPC-PEP solution was prepared by adding 15 ml of 2% hydroxypropylcellulosum (HPC) to 15 ml of peplomycin (PEP)/physiological saline solution in which 90 mg PEP had been dissolved. Accordingly, a total of 30 ml of the mixed solution was used. On day 7 after treatment, a clinical evaluation was made through endoscopic observation and urine cytodiagnosis. The results of the evaluation were expressed by assigning appropriate grades for the improvements made. As for the overall clinical effects, 10 patients demonstrated excellent improvement (CR) but 26 patients exhibited no improvement (NC). The overall clinical efficacy for all cases was 58%. When the evaluation was made according to severity (T1, T2, or T3), the results were as follows: of 43 T1 patients, 9 patients were judged CR, and 23 patients were PR; and of 15 T2 patients, 1 patient was CR and 3 patients were PR. However, all T3 patients were NC. The clinical efficacy for the T1 and T2 groups was 74.4% and 26.4%, respectively. A significant difference was observed between the T1 group and the T2 and T3 groups (p less than 0.05). Evaluation made according to the degree of histopathological differentiation (G1, G2 and G3) demonstrated the following results: of 23 G1 cases, 6 cases were CR, 9 cases were PR; of 32 G2 cases, 4 cases were CR and 16 cases were PR; and of 7 G3 cases, only 1 patient was found to be PR.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Aged, 80 and over; Bleomycin; Cellulose; Delayed-Action Preparations; Drug Evaluation; Emulsions; Female; Humans; Instillation, Drug; Male; Middle Aged; Neoplasm Staging; Peplomycin; Urinary Bladder Neoplasms

A new animal model for intravesical chemotherapy of bladder cancer was prepared by transplanting BC-47 cells into the bladder wall of syngenic ACI/N rat and later transurethral cauterization of the urothelium covering the developed solid tumor, and compared with two common models. One of the models was prepared by similarly transplanting the tumor cells without further treatment and another by transurethral instillation of the tumor cells into cauterized bladder. Tumor transplantation and denudation were both 100% successful in the new model and was superior to those in two common models. The new model was more sensitive to peplomycin than the common model prepared by transplanting the tumor cells into bladder wall without cauterization of the urothelium, while the sensitivity to adriamycin were practically the same as that of the common model. This difference may be due to presence of the urothelium, which seemed to inhibit a contact of intravesically administered peplomycin with tumor. It could be considered that the new model with denuded tumor has a high predictivity on the clinical effect for drug candidates.

Topics: Administration, Intravesical; Animals; Bleomycin; Disease Models, Animal; Doxorubicin; Female; Neoplasm Transplantation; Peplomycin; Rats; Rats, Inbred ACI; Urinary Bladder; Urinary Bladder Neoplasms

Multivariate analysis by Cox's proportional hazard model was performed on 71 bladder cancer patients treated by radical cystectomy to clarify factors affecting survival and to evaluate the efficacy of postoperative adjuvant chemotherapy. Clinicopathologic data included in the analysis were age, sex, interval from onset of symptoms to first consultation, prior tumor history, year of operation and tumor characteristics: size, number, growth pattern, stage, grade, mode of infiltration, lymphatic invasion, lymph-node metastasis and lymphocyte infiltration around tumors. Analysis revealed that stage is the most statistically significant factor for survival (p less than 0.0001); followed by year of operation (p less than 0.05) and lymph node metastasis (p less than 0.1). The above three determinants yielded hazard ratios of 16.6 for stage (pT3a-pT4 vs. pTis-pT2), 2.7 for year of operation (1978-1982 vs. 1983-1987) and 2.4 for lymph node metastasis (positive vs. negative). Postoperative adjuvant chemotherapy consisting of cisplatin, peplomycin and mitomycin C (PPM therapy) seemed to improve survival, when the influence of the major prognostic factors were adjusted by the proportional hazards model. The authors conclude that stage and lymph node metastasis should be considered when postoperative adjuvant treatment is selected for patients with bladder cancer treated by radical cystectomy, and that further prospective randomized trials are mandatory to confirm the efficacy of postoperative adjuvant PPM therapy suggested by the present retrospective multivariate analysis.

Topics: Adult; Aged; Analysis of Variance; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Female; Humans; Lymphatic Metastasis; Male; Middle Aged; Mitomycin; Mitomycins; Neoplasm Staging; Peplomycin; Postoperative Care; Prognosis; Urinary Bladder; Urinary Bladder Neoplasms

Using an in vitro colony forming assay system, cytotoxic effects of anticancer drugs, adriamycin (ADM) and peplomycin (PEP), and the combined effect of hyperthermia and anticancer drugs on cultivated KK-47 cells were investigated. From the response curves obtained at 42 and 43 degrees C hyperthermia, 20% growth inhibition time (IT20) at 42 and 43 degrees C hyperthermia and 50% growth inhibition time (IT50) at 43 degrees C were calculated. The IT20 and IT50 hyperthermia were combined with a 2-hour treatment of each of the anticancer drugs. When the hyperthermia was combined with various concentrations of ADM ranging from 0.005 to 0.1 microgram/ml, enhanced cell killing effects were obtained at the concentrations of less than 0.02 microgram/ml of ADM, whereas, there was no increase in cell killing effect at the concentrations of more than 0.05 microgram/ml of ADM. The combination of hyperthermia with PEP considerably enhanced the cell killing effects with an increase of PEP concentration.

Topics: Bleomycin; Doxorubicin; Hot Temperature; Humans; Peplomycin; Tumor Cells, Cultured; Tumor Stem Cell Assay; Urinary Bladder Neoplasms

Topics: Administration, Intravesical; Bleomycin; Cellulose; Emulsions; Humans; Peplomycin; Urinary Bladder; Urinary Bladder Neoplasms

Cisplatin, doxorubicin, cyclophosphamide and peplomycin have been used in combination for urothelial cancer. Doxorubicin 30-40 mg/m2 and cyclophosphamide 300-400 mg/m2 were administered on day 1, cisplatin 12-15 mg/m2 daily for 5 days and peplomycin 4-6 mg/m2/day by continuous infusion for 5 days. Courses were given at 3-4-weekly intervals in principle. Eight patients with measurable locally advanced or metastatic disease were treated with this protocol, and four achieved partial remission (objective response 50%). None of the four patients with locally advanced disease showed any response, (three no change, one progressive disease). Another eight patients were treated with adjuvant chemotherapy after radical surgery. Of the four patients with high-grade (G3) and high-stage (pT3b-pT4) bladder cancer, three relapsed 7-14 months after surgery, leaving one who still remains disease-free after 8 months. These preliminary results seem to indicate that our protocol is insufficient for adjuvant chemotherapy after radical surgery for high-grade and high-stage urothelial cancer.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Peplomycin; Postoperative Care; Urinary Bladder Neoplasms

The cytotoxic effect of bleomycin and peplomycin was compared using a methylcellulose monolayer assay for the cultivation of human tumor cells. In 3 out of 4 samples from human malignant melanomas peplomycin proved to be more cytotoxic than bleomycin. Peplomycin was more cytotoxic than bleomycin in 1 of 5 myosarcoma samples, whereas 2 samples from squamous cell carcinomas of the lung showed identical dose response curves. In 1 carcinoma of the gall bladder peplomycin was more toxic than bleomycin.

Topics: Bleomycin; Cells, Cultured; Colonic Neoplasms; Colony-Forming Units Assay; Dose-Response Relationship, Drug; Humans; Lung Neoplasms; Melanoma; Myosarcoma; Peplomycin; Tumor Stem Cell Assay; Urinary Bladder Neoplasms

We examined the chemotherapies with cis-diamminedichloroplatinum (II) (CDDP) alone and in combination, using the human bladder cancer xenografts (BT-8 and BT-11 strains) in athymic nude mice (BALB/C), to establish the most effective and useful method for urothelial cancer in clinical use. First, to assess the anti-tumor activities of single-drug and our devised VPM or CisCF combination chemotherapies, experiments were done using the BT-8 strain bladder cancer (transitional cell carcinoma and grade III). The schedule and dosage of each chemotherapy were as follows. Vincristine (VCR): 0.06 mg/kg, days 1-6, peplomycin (PEP): 0.9 mg/kg, days 1-6, methotrexate (MTX): 0.6 mg/kg, days 1-6, cytosine arabinoside (Ara-C): 3 mg/kg, days 1-6, 5-fluorouracil (5-FU): 30 mg/kg, days 1-6, adriamycin (ADM): 3 mg/kg, days 1-6, cyclophosphamide (CPM): 10 mg/kg, days 1-10, and CDDP: 2.5 mg/kg, days 1-6. These were for single-drug chemotherapies. The VPM combination consisted of VCR (0.06 mg/kg, days 1 and 4), PEP (0.3 mg/kg, days 1-6) and MTX (0.3 mg/kg, days 2, 3, 5 and 6), and the CisCF combination consisted of CDDP (2.5 mg/kg, days 1 and 4), Ara-C (3 mg/kg, days 1 and 4) and 5-FU (15 mg/kg, days 2, 3, 5 and 6). The control group was given normal saline of 0.1 ml/20 g body weight, intraperitoneally. All anti-cancer drugs were also given intraperitoneally. Secondly, to assess the anti-tumor activities of CDDP alone and various modes of combination chemotherapies with or without CDDP, the following experiments were done using the BT-11 strain bladder cancer (a mixed type of transitional cell carcinoma and squamous cell carcinoma). CDDP: 2.5 mg/kg, days 1-6. VPM X 2: VCR (0.04 mg/kg, days 1, 4, 8 and 11), PEP (0.2 mg/kg, days 1-4) and MTX (0.2 mg/kg, days 2, 3, 5, 6, 9, 10, 12 and 13). CisCF X 2: CDDP (2.5 mg/kg, days 1 and 8), Ara-C (3 mg/kg, days 1, 6, 8 and 13) and 5-FU (30 mg/kg, days 3, 4, 5, 10, 11 and 12). VPM-CisCF (I): VCR (0.04 mg/kg, days 1 and 4), PEP (0.2 mg/kg, days 1-7), MTX (0.2 mg/kg, days 2, 3, 5 and 6), CDDP (2.5 mg/kg, day 8), Ara-C (3 mg/kg, days 8 and 13), and 5-FU (30 mg/kg, days 10-12).(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Cytarabine; Female; Fluorouracil; Humans; Methotrexate; Mice; Mice, Nude; Neoplasm Transplantation; Peplomycin; Urinary Bladder Neoplasms; Vincristine

In order to study the effect of Bestatin on superficial bladder cancer, the drug was used in combination with hyperthermia and Peplomycin therapy. The study was made using the following 2 groups. Group 1; Hyperthermic treatment with Peplomycin was used in 6 cases of bladder cancer. Group 2; Bestatin was given in combination with hyperthermia and Peplomycin in 15 cases of bladder cancer. As a result, complete or partial regression was obtained in 1 and 5 cases in Groups 1 and 2 respectively. Therefore, the combined use of Peplomycin and Bestatin in hyperthermic treatment for superficial bladder cancer appeared to be effective. Degeneration of tumor cells, irregularity of tumor structure, interstitial edema, fibrosis and cell infiltration were observed in the surgical specimens taken from effective cases, although the mechanism of action of Bestatin on tumors was clearly demonstrated upon histological examination.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Female; Humans; Hyperthermia, Induced; Leucine; Male; Middle Aged; Peplomycin; Urinary Bladder Neoplasms

Topics: Adolescent; Adult; Aged; Aging; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Doxorubicin; Female; Humans; Kidney; Kidney Function Tests; Male; Middle Aged; Peplomycin; Urinary Bladder Neoplasms; Urinary Diversion

Two VPM-CisCF chemotherapy regimens (vincristine (VCR), peplomycin (PEP), methotrexate (MTX), cis-diamminedichloroplatinum (II) (CDDP), cytosine arabinoside (Ara-C) and 5-fluorouracil (5-FU), established using human bladder cancer xenografts in nude mice were applied for advanced urothelial cancer. VPM-CisCF (I) consisted of 0.4 mg/m2 VCR on days 1 and 4, 2 mg/m2 PEP on days 1-7, 2 mg/m2 MTX on days 2, 3, 5 and 6, 20 mg/m2 CDDP on days 8, 20 mg/m2 Ara-C on days 8 and 13, and 150 mg/m2 5-FU on days 10-12. VPM-CisCF (II) consisted of 0.6 mg/m2 VCR on days 1 and 3, 3 mg/m2 PEP on days 1-4, 3 mg/m2 MTX on days 2 and 3, 35 mg/m2 CDDP on day 4, 20 mg/m2 Ara-C on days 4 and 7, and 200 mg/m2 5-FU on days 5 and 6. These doses were adjusted for each case: the above mentioned dose x [(80/(40 + Age))2 + (Karnofsky's performance status/100)2]. VPM-CisCF (I) was administered to 6 patients (bladder cancer and transitional cell carcinoma), intra-arterially in two cases. One patient showed a complete response and survived for 7 months, three partial response (PR) surviving for 13, 8 and 37 (arterial-infused case) months, one showed minor response (MR) surviving for 4 months, and one had no change (NC) surviving for 5 months. VPM-CisCF (II) was administered to 11 patients (1 ureteral cancer, 1 renal pelvic cancer, 9 bladder cancer, and 10 transitional cell carcinoma except a case of mixed type of transitional cell carcinoma and squamous cell carcinoma). Four of the patients who had PR survived for 9, 8, 8 and 7 (alive) months, two who had MR survived for 8 and 4 months, three who had NC survived for 6, 4 and 4 months, and who two had progressive disease survived for 8 and 6 months. The major toxicities were myelosuppression and gastrointestinal symptoms, especially nausea and vomiting, but the treatment was well-tolerated.

Topics: Adult; Aged; Animals; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Cisplatin; Cytarabine; Female; Fluorouracil; Humans; Kidney Neoplasms; Male; Methotrexate; Mice; Mice, Nude; Middle Aged; Neoplasm Transplantation; Peplomycin; Ureteral Neoplasms; Urinary Bladder Neoplasms; Vincristine

Hyperthermic intravesical perfusion therapy using peplomycin (40 micrograms/ml) in distilled water at 43 degrees C as a perfusate was performed for 2 to 3 hours in 18 patients with superficial bladder tumors and 2 with deep bladder tumors. The therapeutic efficacy was determined by cystoscopy, ultrasonography and/or CT scan. Complete and partial tumor regression was obtained in 1 and 3 of the 18 patients, respectively. There was no tumor regression in the 12 patients. Most of the patients studied had bladder discomfort such as irritation, urinary frequency and so on, during and/or after perfusion. None of the patients developed acute pyelonephritis.

Topics: Aged; Bleomycin; Carcinoma, Transitional Cell; Chemotherapy, Cancer, Regional Perfusion; Combined Modality Therapy; Female; Humans; Hyperthermia, Induced; Male; Middle Aged; Peplomycin; Prognosis; Urinary Bladder Neoplasms

Distilled water containing 40 micrograms/ml peplomycin and 2% ethanol was used as a perfusate in 8 patients with superficial bladder tumors and 2 with deep bladder tumors for 2 hours at 43 degrees C. In addition, immediately before the perfusion treatment, 5 mg of peplomycin was injected intramuscularly. Prior to treatment, the nature and extent of the tumors were determined by ultrasonography, cystoscopy and cystography. The therapeutic effect of the hyperthermic perfusion was evaluated by the same manner as used previously. Partial tumor regression was obtained in 6 of the 8 patients with superficial bladder tumors. The 2 patients with deep bladder tumors showed no tumor regression. Most of the patients had bladder discomfort such as irritation, pollakisuria and so on, during and/or after perfusion. No patient developed acute pyelonephritis.

Topics: Aged; Antibiotics, Antineoplastic; Bleomycin; Carcinoma, Transitional Cell; Combined Modality Therapy; Ethanol; Female; Humans; Hyperthermia, Induced; Male; Middle Aged; Peplomycin; Perfusion; Urinary Bladder Neoplasms

Four patients with urinary bladder carcinoma were treated by combination therapy which consisted of hyperthermia vesical irrigation of two anticancer drugs (peplomycin and picibanil), intravesical instillation of those drugs and radiation. Following the therapeutic method we planned, 40 mg of peplomycin and 10 KE of picibanil in 1,500 ml of sterile distilled water was irrigated at 42 to 43 degrees C into the bladder for 3 hours; 40 mg of peplomycin and 10 KE of picibanil in 40 ml of sterile distilled water was instilled into the bladder; and, the focus was irradiated with 60Co to a focal dose of 200 rad 30 minutes later. This pattern of treatment was repeated once a week, 3 to 5 times in total. On the days this pattern was not taken, 5 KE of picibanil in 20 ml of sterile distilled water was instilled into the bladder cavity. Complete response was observed in one patient and partial response in 3 patients. The side effect was temporary irritable bladder symptom.

Topics: Aged; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Transitional Cell; Combined Modality Therapy; Female; Humans; Hyperthermia, Induced; Male; Middle Aged; Peplomycin; Picibanil; Radiotherapy Dosage; Urinary Bladder Neoplasms

Topics: Adult; Aged; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Capsules; Carcinoma, Transitional Cell; Cisplatin; Combined Modality Therapy; Humans; Male; Middle Aged; Mitomycin; Mitomycins; Peplomycin; Urinary Bladder Neoplasms

A peplomycin-silicone (PS) bullet containing 130 mg peplomycin, which was steadily released over a long period, was prepared. The PS bullet was then affixed to the top of a 3-way balloon catheter, to form a so called "PS bullet catheter". About 80% of the peplomycin was gradually released over 2 weeks from the PS bullet catheter. Using this device hyperthermic treatment using cepharanthine (biscoclaurin ++ alkaloid) in the irrigant was performed in 15 cases of superficial bladder tumor. Five daily hyperthermic treatments were carried out and all patients retained the PS bullet catheter in the urinary bladder for 2 weeks. Marked tumor regression was noted in 10 of the 15 cases. In addition, partial tumor regression occurred in 4 of the remaining 5 cases. None of these cases had irreversible side effects. This therapy had a good effect on superficial bladder tumor and it is considered that the PS bullet catheter would be useful for cancer therapy.

Topics: Aged; Alkaloids; Benzylisoquinolines; Bleomycin; Delayed-Action Preparations; Female; Hot Temperature; Humans; Male; Middle Aged; Peplomycin; Silicones; Urinary Bladder; Urinary Bladder Neoplasms; Urinary Catheterization