[Prophylaxis of recurrence of superficial bladder tumor by intravesical chemotherapy].

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.

[Prophylaxis of recurrence in superficial bladder carcinoma by intravesical chemotherapy--comparative study between instillation of combined double anticancer agents and single anticancer agent].

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.

[Influence of peplomycin on pulmonary function (PaO2, %DLco) in patients with oral carcinoma].

The pathogenesis of pulmonary fibrosis (PF) induced by bleomycin and its derivative, peplomycin (PEP), is insufficiently understood. To prevent PF and to administer PEP safely, we examined the influence of PEP on pulmonary function in 135 patients who underwent concomitant chemo (PEP + 5-FU)-radio (60Co) therapy and pulmonary function tests. In the inductive therapy, 5 mg of PEP was intramuscularly injected three times a week and a total of 41.6 +/- 14.3 mg was administered. Of the patients, 98 received oral azelastine hydrochloride (AZH, 4 mg/day) during the inductive therapy with the aim of prophylaxis of PF. The oxygen partial pressure in arterial blood (PaO2) only slightly decreased from 84.2 +/- 12.1 mmHg before treatment to 82.8 +/- 12.5 mmHg after treatment, while, carbon oxide diffusion (%DLco) decreased after treatment in most patients (p < 0.001, by paired t test) with mean values before treatment of 106.3 +/- 24.5% and after treatment 99.5 +/- 24.9%. The decrease of %DLco was associated with the dose of PEP until about 40 mg but further decreases of %DLco were not prominent. In the patients who underwent oral AZH, the decrease of %DLco weaker than that in patients without AZH: the decrease rates of %DLco in the former and latter were 4.3 +/- 9.4% and 14.1 +/- 15.9%, respectively. From the chest X-ray examination, mild PF was suspected in three patients but no advancement of PF or clinical symptoms were observed. From these results, it was concluded first that %DLco is more useful than PaO2 as the predisposing risk factor for PF, second that the decrease of %DLco depends on the dose of PEP until about 40 mg, third that AZH is expected to inhibit PEP-induced PF, and fourth that a small dose (20-40 mg) of PEP can be administered without inducing PF if care is exercised as to the patient's age, general condition and the value of %DLco in the use of PEP.

Cisplatin, vindesine, pepleomycin and concurrent radiation therapy following esophagectomy with lymph adenectomy for patients with an esophageal carcinoma.

Between 1986 and 1991, 35 patients with esophageal cancer (TNM stages II-IV) underwent transthoracic esophagectomy with lymph adenectomy and were subsequently treated with 5,000 cGy of radiation (days 1-40) and concurrently with two courses of chemotherapy (cisplatin, vindesine and pepleomycin, days 21-26 and 49-54). Results were compared with those of 26 historical control patients, treated with radiation since 1981. Tolerance in all patients was good. The survival rate at 5 years was significantly improved for the multimodality-treated patients (30.9 +/- 9.4%), as compared with findings in historical controls (5.1 +/- 4.8%). The concurrent chemoradiation therapy using these three drugs following extensive surgery is worthy of consideration for patients with a localized esophageal cancer.

[Preventive effect of ticlopidine on peplomycin pulmonary fibrosis].

A comparative clinical study examined the preventive effect of ticlopidine hydrochloride (hereinafter referred to as ticlopidine, anti-platelet drug) on Peplomycin sulfate (hereinafter referred to as Peplomycin) pulmonary fibrosis. In clinical evaluation, pulmonary function (PaO2, DLco) and biological fibrosis markers (angiotensin I converting enzyme, type III procollagen peptide, phospholipid) were measured. PaO2 and DLco using ticlopidine showed improvement, but statistical significance was not observed. Changes in biological fibrosis markers due to Peplomycin administration were observed in accordance with earlier experiments. Importantly however, the variance of type III procollagen peptide in the ticlopidine group was significantly suppressed (p less than 0.10). As a result, ticlopidine has the potential to prevent Peplomycin pulmonary side effects during clinical use.