tretinoin and Leukoplakia

Internal dosimeters that can provide information about responses to chemopreventive agents in a short time would be invaluable for planning treatment protocols for large-scale intervention trials. Micronuclei meet many of the prerequisites of a good intermediate endpoint. They can be quantified in cultured cells, animal tissues and human exfoliated cells and biopsies. With image scanning, up to 10(5) cells can be screened for micronuclei within a few minutes. The predictive value of micronuclei has been demonstrated using cultured cells exposed to carcinogens and chemopreventive agents and using oral mucosa of betel-quid chewers. DNA adducts, as detected by 32P-postlabelling techniques, could conceivably be another potentially useful marker. However, prior to their use in intervention trials, interindividual variations in their levels in primary, secondary and nontarget tissues and the relationship with doses of carcinogens must be established. The wide scatter of DNA adduct levels in the bronchial mucosa of smokers and of nonsmokers reveals one difficulty that can be encountered using this marker in intervention trials.

Topics: Animals; Antineoplastic Agents; Carcinogens; Cell Transformation, Neoplastic; Cells, Cultured; Clinical Trials as Topic; DNA; Humans; Leukoplakia; Micronucleus Tests; Smoking; Tretinoin

A group of 35 patients with leukoplakia of the vulva was treated with 13-cis retinoic acid applied topically. Complete or partial remission occurred in 17 patients. Parallel determination of retinol level in sera revealed its increased value as compared to healthy persons.

Topics: Administration, Topical; Adult; Aged; Drug Evaluation; Female; Humans; Leukoplakia; Middle Aged; Tretinoin; Vulvar Neoplasms

Repeated topical application of 13-cis-retinoic acid resulted in complete disappearance of leukoplakia of the vulva in 8 out of 16 patients, among them 2 out of 3 with recurrence after vulvectomy. A considerable regression of leukoplakia was seen in 7 other patients, usually after 1 to 2 months of daily retinoid treatment. After 2-4 months of maintenance therapy and during 3-7 months of the follow up period no recurrences were seen. Side effects of treatment could be managed. Serum retinol level was found to be lower in patients then in healthy subjects. The results suggest that patients with chronic epithelial vulvar dystrophies could benefit from local retinoid treatment, especially in cases with advanced dystrophies until now qualified for vulvectomy.

Topics: Administration, Topical; Adult; Antineoplastic Agents; Female; Humans; Isotretinoin; Leukoplakia; Middle Aged; Tretinoin; Vulvar Neoplasms

15 patients with superficial basaliomas or premalignant epithelial neoplastic disorders (actinic keratosis, leukoplakia, Bowen's disease) were treated locally over three weeks with retinoic acid (RA) alone or in combination with 5-fluorouracil (5-FU). In 11 cases the lesions disappeared clinically, however, only 5 patients proved to be cured by histological examination. 4 of them were treated with RA combined with 5-FU. There was a decrease of the 3H-index after the first week and an increase after the third week of treatment. These findings suggest, that RA inhibits the proliferation of neoplastic keratinocytes and stimulates the proliferation of normal epidermal cells. Retinoic acid, therefore, has an inhibitory effect on epithelial neoplasias, particularly in combination with 5-FU. Since local therapy with RA and 5-FU is not sufficient for routine clinical purposes in all cases, their use should be restricted to selected patients.

Topics: Aged; Carcinoma, Basal Cell; Drug Therapy, Combination; Female; Fluorouracil; Humans; Keratosis; Leukoplakia; Light; Lip Neoplasms; Male; Middle Aged; Mouth Neoplasms; Neoplasms, Radiation-Induced; Precancerous Conditions; Scalp; Skin Neoplasms; Thorax; Tretinoin; Vitamin A

Topics: Administration, Oral; Adolescent; Adult; Aged; Child; Darier Disease; Female; Humans; Ichthyosis; Keratoderma, Palmoplantar; Keratosis; Leukoplakia; Male; Middle Aged; Pityriasis Rubra Pilaris; Psoriasis; Skin Neoplasms; Tretinoin; Vitamin A