Chemotherapy with cisplatin and 5-fluorouracil for penile and urethral squamous cell carcinomas

Abstract

Six men with either recurrent (n = 4) or unresectable (n = 2) squamous cell carcinoma of the penis (n = 5) and urethra (n = 1) received chemotherapy with cisplatin intravenously at a dose of 100 mg/m2. This was followed 24 hours later by a continuous intravenous infusion of 5-fluorouracil (5-FU) at a dose of 960 mg/m2/d for five days every 3 to 4 weeks. There was universal alopecia. The other toxicities were mild and consisted of mucositis, nausea, vomiting, reversible creatininemia, and transient azotemia. After chemotherapy, five patients had a clinical partial response and one had a complete response. Of the five patients with no metastases, three had residual unresectable tumors. These three patients received radiation and survived for 6, 8, and 20 months after the start of chemotherapy. The other two patients were rendered disease-free by surgery. The first patient, who was a partial responder to chemotherapy, survived for 26 months. The second patient, who was a clinical complete responder, had excision of microscopic disease and is disease-free at 32+ months after the start of chemotherapy. This is the first article to report that the combination of cisplatin and 5-FU is active in penile and urethral carcinomas. After chemotherapy, surgery may be useful in selected patients to accurately assess response and excise localized residual tumors. Patients rendered tumor-free may achieve long-term survival.

Cancer of the penis

“…Hussein et al reported one complete response and five partial responses in six men with recurrent or unresectable squamous cell carcinoma of the penis [88]. Shammas et al treated eight patients with advanced squamous cell carcinoma of the penis, two of whom achieved a partial response, one requiring surgery and the other requiring surgery and radiotherapy to achieve a complete response [89].…”

Successful management of female urethral carcinoma with radiation therapy and concurrent chemotherapy

“…The disparity in survival rates has led to the addition of concurrent chemotherapy for proximal, higher stage lesions. A combination of radiation therapy and chemotherapy using 5-flurouracil and cisplatin has been shown to provide effective treatment for locally advanced urethral carcinoma in females (Hussein et al, 1990). A single institution study by Gheiler demonstrated the benefits of combination therapy, as 88% of patients treated with RT and concurrent 5-FU/cisplatin were alive NED at five years (Gheiler et al, 1998).…”

A case of local advanced penile cancer treated with multimodality therapy

“…However, a standard scheme of combination therapy is undefined. Hussein et al [16] reported that a novel chemotherapeutic combination (CDDP and 5-FU) achieved partial responses in five of six patients (five cases of penile cancer and one of SCC of the urethra). In SCC of the anus or larynx, combination therapy, multiagent chemotherapy, and surgery or radiation therapy resulted in improved outcomes [17,18].…”