pirarubicin and Penile-Neoplasms

A 72-year-old man with genital ulcerative tumor was introduced to our hospital in December 1997. The pathological examination revealed well differentiated squamous cell carcinoma. A diagnosis by computed tomography and magnetic resonance imaging indicated that a locally advanced penile carcinoma had infiltrated the urethra, prostate, pubic bone and there was also bilateral inguinal lymphoadenopathy. Linac irradiation (40Gy/4 weeks) combined with once-a-week administration of THP-ADM were indicated. One month after the combination therapy, the tumor size had become small enough to allow curative surgical treatment. Pathological examination revealed no positive margin. For eight years since this radical treatment, the patient has been healthy with no local recurrence and no distant metastatic lesion.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Combined Modality Therapy; Doxorubicin; Drug Administration Schedule; Humans; Lymph Node Excision; Male; Penile Neoplasms; Survivors

A 60-year-old [correction of 68] male was referred to our hospital because of a penile tumor with necrosis. Pathological examination of the penile tumor and superficial inguinal lymph nodes in biopsy revealed well differentiated squamous cell carcinoma (SCC) and the SCC tumor marker was elevated. TNM classification was T2, N2, M0 according to findings obtained by computed tomography (CT) and magnetic resonance imaging (MRI). We diagnosed the tumor inoperable radically and administered 10 mg peplomycin once a week for 10 weeks intravenously. The SCC marker level was not reduced and the tumor was not changed on MRI. Then, we performed combined pirarubicin treatment and radiotherapy. The patient received linac radiotherapy between 40 Gy/4 weeks/20 fractions. Pirarubicin, 10 mg/m2, was administered once a week for 4 weeks during irradiation intravenously. After the combined therapy, the SCC marked level was reduced to the normal range and the tumor was reduced. We performed radical operation. Pathological diagnosis revealed no viable tumor cells. The patient was alive with no evidence of disease a year later. This combined therapy is suggested to be useful.

Topics: Antibiotics, Antineoplastic; Carcinoma, Squamous Cell; Combined Modality Therapy; Doxorubicin; Humans; Male; Middle Aged; Penile Neoplasms

Five patients with penile cancer were treated with radical radiotherapy combined with concurrent THP-ADM. No patient demonstrated distant metastasis, but three patients had regional nodes metastasis at first presentation. Delivered dose was 60 Gy over 8-weeks and 10 mg/m2 of THP-ADM was administered once a week during irradiation. Three of the five cases (60%) achieved complete response. Regarding the primary tumor complete response was noted in three cases (60%) and partial response in two (40%). Regarding the lymph nodes complete response was observed in two cases (67%) and no change in one. Histological effect upon the primary tumor was Grade IV in three cases and Grade IIB in two according to Obosi-Shimosato's criteria. That of the metastatic lymph nodes was Grade IV in one case. Three patients (60%) were alive with no evidence of disease with a median follow up of 27 months. Leukocytopenia and erosion of the penile skin were observed in all cases and meatal stenosis in one. All of these toxicities were acceptable. These results suggested that this combined therapy is effective for penile cancer and useful for the penis preserving treatment.

Topics: Aged; Aged, 80 and over; Antibiotics, Antineoplastic; Combined Modality Therapy; Doxorubicin; Humans; Infusions, Intravenous; Male; Middle Aged; Penile Neoplasms; Prognosis; Radiotherapy Dosage