Primary clinical effects of PP therapy (cisplatin and peplomycin) and TPP therapy (4′-O-tetrahydropyranyladriamycin, cisplatin and peplomycin) for oral cancer

Abstract

Background" A comparison of chemotherapy with PP (cisplatin, CDDP; and peplomycin, PEP) and TPP (4'-0-tetrahydropyranyladriamycin: THP-ADM, CDDP and PEP) in the treatment of oral cancer. Methods: This study included 159 out of 199 patients who had visited the collaborating institutions' hospitals, and who had been registered in the Examination Meeting of Chemotherapy for Oral Cancer during the 2-year period from June 1990 to May 1992. Ninety-seven patients underwent PP therapy and 62 underwent TPP therapy. In PP intravenous infusion therapy, 60-80 mg of CDDP per m 2 was administered on day 1, followed by infusion of 5-7.5 mg of PEP per m 2 from day 2 until day 6. In the PP intra-arterial infusion therapy, in which the drugs were infused in a retrograde fashion into the superficial temporal artery, 50-70 mg of CDDP per m 2 was infused on day 1, followed by infusion of 5 mg of PEP per m 2 from day 2 until day 6. In both the intravenous and intra-arterial TPP therapy regimens, 20 mg ofTH P-ADM per m 2 was infused on day 1, followed by infusion of 50 mg of CDDP per m 2 on day 2, and infusion of 5 mg of PEP per m 2 from day 3 until day 7. Results: The response rate of TPP therapy was 64.5%, which was not significantly different from the 53.6% obtai ned with PP therapy. However, the complete response (CR) rate with TPP therapy was 22.6 %, significantly higher than the 9.3% with PP therapy. The response rate ofTPP intra-arterial infusion therapy was particularly high (92.3%), and significantly higher than that of PP therapy. The response rate ofTPP intra-arterial infusion therapy was very high (100.0%) in stage I and II patients and in primary cancers of the tongue, gingiva, buccal mucosa, and hard palate. The toxicity of TPP and PP therapies resulted in a high incidence of nausea/vomiting and anorexia. Skin disorders and epilation were observed at high rates with TPP therapy, and incidences were particularly high (100.0%) in the TPP intra-arterial infusion therapy group. The incidence of leukopenia was high in patients treated with TPP therapy but was not severe. Conclusion:The results of this study suggest that TPP therapy is more effective than PP therapy in the treatment of oral cavity cancer. Although TPP therapy was associated with skin abnormalities, alopecia, and leukopenia as side effects, there was no influence on subsequent treatment. TPP intra-arterial infusion therapy appears promising in the treatment of oral cancer.