Masakazu Harada

Chemotherapy administered using two-route infusion of cisplatin and sodium thiosulfate and intravenous infusion of vinblastine and peplomycin in patients with oral cancer

The therapeutic effects of neo-adjuvant chemotherapy administered by two-route infusion of cisplatin and its antidote, sodium thiosulfate, and intravenous infusion of vinblastine and peplomycin were studied in 22 patients with previously untreated squamous cell carcinoma of the oral cavity or maxillary sinus. The overall response rate to chemotherapy was 90.9%, with a complete response in 12 patients (54.5%), a partial response in 8 patients (36.4%), and no change in 2 patients (9.1%). Histologic assessment showed a grade V response in 7 patients (31.8%), grade IV in 3 patients (13.6%), grade III in 5 patients (22.7%), grade II in 4 patients (18.2%), and grade I in 3 patients (13.6%). The cumulative 5-year survival rate, including 3 patients who died of another disease, was 72.2%. Leukocytopenia, an important side effect apparently induced by vinblastine, was seen, but no life-threatening complications occurred. Renal toxicity by cisplatin was minimal because of the use of sodium thiosulfate and fosfomycin. These data indicate that this mode of chemotherapy may be more effective for treating head and neck cancer than ordinary chemotherapy, from clinical and histologic standpoints. The high complete-response rate is especially noteworthy. No serious side effects or reductions in treatment period occurred. The results are preliminary and additional studies using a larger patient population are needed.

Significance of combined neoadjuvant chemotherapy on oral cancer. 1. The clinical effects of cisplatin-vinblastine-peplomycin(CVP) combination chemotherapy included in two route administration and its prognostic significance.

未治療の口腔, 上顎洞, 口峡咽頭原発の扁平上皮癌患者35名に対し, シスプラチンとその拮抗剤であるチオ硫酸ナトリウムを用いた2経路注入法とビンブラスチンとペプロマイシンの静脈内投与から成るネオアジュバント化学療法を施行し, その治療効果について検討した。化学療法の奏効率は91.4%で, CR率は57.1%であった。非担癌他病死例を除外すると, 累積5年生存率はCR群では100%であり, PR+NC群では87.5%であった。本化学療法は適正な支持療法を行うことにより, 短期間で遂行することが可能である。20名のCR患者の内12名に縮小手術が施されたが, 全ての患者が非担癌で良好な口腟機能を保持している。これらのデータは, この化学療法のレジメンが頭頸部癌の治療により効果的であることを示している。この結果はまだ予備的なものであり, さらに症例を加えて検討する必要がある。