retinamide and Precancerous-Conditions

To report long term therapeutic effect in patients with esophageal pre-cancerous lesions in high-risk area of esophageal cancer.. The therapeutic trial enrolled 2,531 cases of severe dysplasia and 3,393 cases of mild dysplasia. A 2-arm randomized, placebo-controlled design was used in which the participants received Zeng Sheng Ping (ZSP, an herbal composite), retinamide or placebo for cases with severe dysplasia and riboflavin or placebo for those with mild dysplasia.. Treatment with ZSP and retinamide decreased malignant transformation rate of severe dysplasia by 52.2% and 43.2%, respectively after 5 years of treatment. When the treatment had been discontinued for 4 years, the rate of malignat transformation was decreased by 42.1% and 38.2% respectively, which remained significantly higher than that of the placebo-treated control. Riboflavin treatment was continued for 9 years. At the end of 5-year medication, the malignant transformation rate decreased by 34.8%, which was not significantly different from that of the placebo control. When the treatment was continued up to 9 years, the rate was further decreased to 37.0%, which became statistically significant.. ZSP, retinamide and riboflavin treatment can effectively prevent esophageal dysplasia from transforming into carcinoma.

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Drugs, Chinese Herbal; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Precancerous Conditions; Tretinoin

Dysplasia of the uterine cervix is a recognized precancerous condition. Because of the observed ability of retinoids to suppress various cell lines in vitro, a number of clinical studies have examined the effect these agents have on cervical dysplasia, with the object of developing a means of chemoprevention of cervical malignancies in women at risk. Three cervical cancer chemoprevention trials with Retinamide II (RII) have been conducted at the Cancer Institute, Chinese Academy of Medical Sciences, Beijing, China. A pilot study used RII to intervene in cases of precancerous cervical dysplasia. Twenty-seven women with mild, moderate, or severe cervical dysplasia, pathologically confirmed, were treated by RII suppositories, 10 mg QD, given intravaginally for 6 months (each course lasting 3 months). The results indicated that after the second course, the overall response rate was 96.29% and the complete response rate was 88.89%. In general, side effects were mild. A little cervical and vaginal irritation was well tolerated. In the second double-blind study, patients with precancerous cervical lesions were randomized into two groups, one treated with RII suppository intravaginally and the other with a placebo, once daily for 50 days in two courses. Precancerous lesions in 68.76% of patients in the treatment arm disappeared, with an overall effective rate of 74.29% after two courses of treatment with RII. Its curative effect was approximately that of laser beam radiation and electrocautery (P > 0.05), and differed significantly (P < 0.01) from that of traditional antiinflammatories. RII can be a major measure in prevention and treatment of cervical cancer in high-incidence areas in China. In the third trial, we are conducting a randomized double-blind study placebo controlled, in a high-incidence area of cervical cancer (Xiang-Yuan county, Shang Xi Province, China). At present, the patients are being followed up and the study will be completed after 2 years.

Topics: Antineoplastic Agents; China; Double-Blind Method; Female; Humans; Incidence; Pilot Projects; Placebos; Precancerous Conditions; Tretinoin; Uterine Cervical Neoplasms

Patients with cervical precancerous lesions were double blindly divided into 2 groups and treated with either Retinamide II (RII) or Riboflavin (VB2) suppository. The suppository containing RII 20mg or VB2 5mg was given intravaginally daily for 100 days, divided into 2 courses. Clinical examination, papanicolaou cytology and tissue biopsy under colposcope were carried out before and after treatment. The results showed that the disappearance rates of precancerous lesions (DRPL) after the second course of treatment with RII or VB2 were 68.5% and 52.00%, and the overall response rates were 74.29% and 56.0%, respectively. 1 or 2 yrs after treatment, DRPL of the RII, Riboflavin and laser groups did not show significant difference (P > 0.05). The statistically significant differences were among the RII, Riboflavin, laser groups and antiphlogistic treatment group (P < 0.01). The results indicate that local application of RII and Riboflavin may serve as chemopreventive agents for cervical cancer.

Topics: Administration, Intravaginal; Double-Blind Method; Female; Follow-Up Studies; Humans; Precancerous Conditions; Riboflavin; Suppositories; Tretinoin; Uterine Cervical Neoplasms

Since 1983, we have been conducting inhibitory therapy for precancerous lesions of the esophagus in two regions of Henan Province considered high-risk areas of esophageal carcinoma. Our goal was to effect a 50% reduction in the canceration rate of marked esophageal dysplasia. By means of a cytological survey, 2531 cases of marked esophageal dysplasia and 3393 cases of mild esophageal dysplasia were selected. The former were randomly divided into 3 groups for antitumor-B (ATB, a mixture of Chinese herbs), retinamide (4-ethoxycarbophenylretinamide) and placebo treatment respectively, and the latter into 2 groups treated with riboflavin and placebo respectively. Treatment was continued for 3 or 5 years (administration rate greater than 90% in all groups) and esophageal cytology reexamined (reexamination rates were 94.1% and 92.5% respectively). Our results were as follows: 1) ATB 3- and 5-year subjects saw the canceration rate of marked esophageal dysplasia drop by 52.2% and 47.3% respectively as compared to control (P less than 0.01). 2) Retinamide lowered the canceration rate by 37.3% after a 3-year treatment period, with this reduction reaching 43.2% after an additional 2 years of treatment with increased dosages (P less than 0.05, P less than 0.01). 3) In the riboflavin group, the canceration rate of mild esophageal dysplasia was reduced by 22.2% and 34.8% after 3 and 5 years of treatment respectively, but these differences were not statistically significant. The above results verify the efficacy of medicamentous inhibitory therapy for esophageal precancerous lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Drugs, Chinese Herbal; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Precancerous Conditions; Riboflavin; Tretinoin

9633 subjects aged 40 to 65 were sampled from high-risk areas for esophageal cancer and examined by esophageal exfoliative cytology. 2531 and 3393 cases of markedly and mildly dysplastic patients were screened out respectively. Those with marked dysplasia were randomized into 3 groups and given respective medications: antitumor B (Chinese herbs), 4-ethoxycarbophenylretinamide (retinamide) and placebo. The subjects with mild dysplasia were randomly divided into 2 groups for riboflavin and placebo treatment. After medication for 3 or 5 years the subjects were reexamined by esophageal exfoliative cytology. The incidence of esophageal cancer in the antitumor B group after taking medication for 3 and 5 years was reduced by 52.2% and 47.3% respectively as compared with the placebo group. These differences were statistically significant (chi 2 = 8.9115, P less than 0.01; chi 2 = 10.9573, P less than 0.01). The incidence of esophageal cancer in the retinamide group after 3 years of medication was reduced by 37.3% as compared with control, while the incidence among patients treated for 5 years dropped by 43.2% relative to control. This difference was statistically significant (chi 2 = 9.2836, P less than 0.01). The incidence of esophageal cancer in the riboflavin group was reduced by 22.2% and 34.8% respectively. The above results indicate that secondary prevention of esophageal cancer is possible and that inhibitory therapy of precancerous lesions of the esophagus is effective in preventing esophageal cancer. This method needs further trial and study in high risk areas of esophageal cancer. The reliability of the experimental results is critically discussed.

Topics: Adult; Aged; Antineoplastic Agents, Phytogenic; Drugs, Chinese Herbal; Esophageal Neoplasms; Female; Follow-Up Studies; Humans; Male; Middle Aged; Precancerous Conditions; Riboflavin; Tablets; Tretinoin

In 1983, intervention of precancerous lesion of esophagus was undertaken in the high risk area of esophageal cancer, Heshun Village, Linxian County. It had been expected that cancerous degeneration rate of esophageal dysplasia should be reduced by 50% so as the prevention of esophageal cancer could become possible. 6758 subjects of the general population aging from 40 to 65 were examined by esophageal exfoliative cytology, 1729 had marked dysplasia and 2411 had mild dysplasia of esophageal epithelium. Those with marked dysplasia were randomized into 3 groups to take their respective medication: antitumor B (Chinese herbs); retinamide (4-Ethoxycarbophenylretinamide) and placebo. The subjects with mild dysplasia were divided randomly into 2 groups for treatment by riboflavin and placebo. 95% of the subjects had taken 90% or more of the total medication for 3 years, at the end of which they were reexamined by esophageal exfoliative cytology. The reexamination rate was 94.1%. The incidence of esophageal cancer in the antitumor B group (3.9%) was reduced by 53% as compared with that of the placebo group (8.3%). This difference had statistical significant (means 2 = 7.672, P less than 0.05). The incidence of esophageal cancer in retinamide and riboflavin groups were reduced by 33.7% and 19% as compared with those of the control groups. The regression rate of dysplasia in the treatment groups were increased than that of the control groups. The above results showed that our hypothesis about the secondary prevention of esophageal cancer is correct. The intervention of precancerous lesion of the esophagus is effective in the prevention of esophageal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Drugs, Chinese Herbal; Esophageal Neoplasms; Female; Humans; Hyperplasia; Male; Middle Aged; Precancerous Conditions; Riboflavin; Tretinoin

The model of precancerous lesions of the bladder in rats was induced by N-butyl-(4-hydroxybutyl) nitrosamide (BBN). The animals were randomly divided into the following 3 groups: 1) given Antitumor-B (Chinese herbs); 2) given 4-ethoxycarbophenylretinamide (Retinamide); and 3) control. After treatment for 13 months the rats were killed for pathomorphological examination of the bladder. The results showed that the incidence of bladder cancer in group 1 and 2 was reduced by 90.7% (P < 0.01) and 75.0% (P < 0.01) respectively after treatment as compared with the control group. Our results provide a useful reference for clinical trial in the prevention of bladder cancer recurrence by using antitumor-B and Retinamide.

Topics: Animals; Antineoplastic Agents, Phytogenic; Butylhydroxybutylnitrosamine; Carcinoma, Transitional Cell; Drugs, Chinese Herbal; Precancerous Conditions; Rats; Rats, Wistar; Tretinoin; Urinary Bladder Neoplasms

Twenty seven women with mild, moderate or severe cervical dysplasia proven by pathology were treated by retinamide RII suppository. Retinamide RII suppository, 10 mg QD, was given intravaginally for six months (three months as a course). Clinical examination, Papanicolaou cytology and tissue biopsy under colposcope were carried out before and after treatment. The results indicated that after the second course, 26 out of 27 patients responded; of them, precancerous lesions disappeared in 24 and even normal squamous epithelium was observed in 3. The overall response rate was 96.29% and the marked response rate was 88.89%. The general side effects were mild. There was little cervical and vaginal irritation which was well tolerated. The results of this clinical trial make available a practical base for chemoprevention of cervical cancer.

Topics: Antineoplastic Agents; Cervix Uteri; Female; Humans; Hyperplasia; Precancerous Conditions; Suppositories; Tretinoin; Uterine Cervical Neoplasms