Cisplatin, vindesine, and mitoguazone in the treatment of esophageal cancer.

Overview

Forty-two patients with epidermoid carcinoma of the esophagus were treated with the three-drug combination of cisplatin, vindesine, and mitoguazone (DVM). Twenty patients had locoregional disease and 22 had extensive disease. Of 39 patients evaluable for response, 16 (41%) had complete or partial remission (95% confidence limits, 26%-56%). Of 14 patients with locoregional disease treated prior to surgery, 12 (86%) had resectable disease. There was one death associated with surgery (7.1%). Six of these 14 patients remain alive and free of disease. The median duration of remission for patients with extensive disease was 3 months (range, 2-8). As was the case for an earlier study involving cisplatin, vindesine, and bleomycin, the dose-limiting toxic effect for DVM was leukopenia (median wbc count nadir, 1800/mm3). No clinical evidence of pulmonary toxicity was seen. DVM had moderate activity in esophageal cancer, with acceptable toxicity. Although the risks of pulmonary damage were decreased, the substitution of mitoguazone for bleomycin did not improve the major dose-limiting toxicity of myelosuppression.