Cisplatin, methotrexate and bleomycin for treating advanced penile carcinoma

Abstract

OBJECTIVE To retrospectively evaluate the efficacy and toxicity of chemotherapy with cisplatinum, methotrexate and bleomycin (CMB) in the adjuvant and palliative setting, and its effect on survival in patients with locally advanced or metastatic penile carcinoma, which carries a very poor prognosis. PATIENTS AND METHODS Thirteen patients (mean age 54 years) with radically resected local and nodal disease (eight), metastatic disease (two) or metastatic recurrence (three) had chemotherapy with CMB between February 1996 and July 2003. In all, 45 treatment courses were given, with a mean (range) of 3.5 (2–6) courses per patient. RESULTS Three of the eight patients with adjuvant treatment showed no evidence of disease after a mean (range) of 54 (41–76) months, while four in this group died from disease progression after a mean of 11 (5–20) months, and one died from treatment‐related toxicity. All five patients with metastatic disease died from disease progression after three had shown temporary signs of regression. CONCLUSIONS Chemotherapy with CMB had little effect on metastatic penile cancer and responses were transient. However, patients with minimal disease after radical local and lymphatic resection seemed to benefit from adjuvant therapy, but the toxicity was high and carried a risk of death.

Cisplatin, Methotrexate and Bleomycin for Advanced Recurrent or Metastatic Penile Squamous Cell Carcinoma

“…In conclusion, our findings suggest that the CMB regimen is effective as adjuvant and/or neoadjuvant chemotherapy for advancedstage PSCC patients, but not for recurrent or metastatic PSCC patients, corroborating the findings by Hakenberg et al [14]. Additionally, 2 patients died of interstitial pneumonitis due to chemotherapy.…”

“…However, 5 patients died due to the toxicity of the regimen [13]. Hakenberg et al treated 13 patients with advanced or metastatic PSCC with a similar regimen to ours, and reported that 3 of the 8 patients treated with adjuvant chemotherapy had no evidence of disease [14]. However, 5 patients with metastatic PSCC died of the disease.…”

Chemotherapy in Penile Cancer

“…Hakenberg and colleagues reported that in a group of eight patients who had adjuvant cisplatinum/bleomycin/methotrexate combination treatment, only four patients remained free of recurrence and one patient died as a result of drug toxicity [Hakenberg et al 2006]. At present, there is a clear recommendation that adjuvant chemotherapy is effective and beneficial after inguinal lymphadenectomy, however there is no evidence as to which, if any, chemotherapy regimen is best in this setting.…”

Carcinoma escamocelular condilomatoso asociado al virus del papiloma humano multimetastásico

“…Si presentan adenopatías inguinales palpables el tratamiento de elecció n en estos casos es la linfadenectomía 6 , mientras que si no existen adenopatías palpables hay controversia sobre el tratamiento complementario para realizar y dependerá del grado de invasió n local del tumor y del grado de diferenciació n celular. En los casos donde existen metá stasis a distancia se indica tratamiento paliativo o quimioterapia con cisplatino, metotrexato y bleomicina que ha demostrado ser eficaz y ha demostrado aumentar la supervivencia en casos de afectació n linfá tica 7 , pero no así en aquellos pacientes con diseminació n tumoral orgá nica.…”