Adriamycin (14-hydroxydaunorubicin) is a new antitumar antibiotic isolated from cultures of Streptomyces, peucetius var. caesius. The structural formula differs from daunomycin only in the substitution of hydroxyl group for the 14th carbon. Adriamycin was reported to have a high therapeutic index in the various solid tumors and the hematologic malignancies.
This paper deals with the clinical evaluation of anticancer effect of adriamycin in 28 patients with malignant tumors. The comparison of myelosuppressive toxic effect was made between the patient, with normal liver function and the patient with liver cirrhosis. 28 patients were 8 cases of malignant lymphoma, 4 cases of acute leukemia, 5 cases of lung cancer; 7 cases of primary hepatoma with liver cirrhosis and 4 cases of metastatic liver carcinoma, originated from stomach, The clinical responses were classified according to Karnofsky criteria.
In malignant lymphoma to leukemia and lung cancer, the response was good as proven data (category 1:59%). Also, in 4 malignant lymphomas which were resistant to previous anticancer chemotherapy, 2 of them responded to adriamycin (category 1:50%)., In primary hepatoma, adriamycin was not so favorable (category 1: 4%) as in metastatic liver carcinoma from stomach (category 1:50%).
Clinical toxicities of adriamycin were anorexia, alopecia, nausea-vomiting, hyperpyrexia and stomatitis in order. The incidence and severity of clinical toxicities were much greater in liver cirrhosis group. In generally, significant leukopenia developed about 7th day after treatment and the day of nadir was about 14th day in both groups. It requires 3 weeks for the normal liver function group to recover from myelosuppressive effect of adriamycin while liver cirrhosis group to requires 4 weeks. The severity of thrombocytopenia and anemia was much less than leukopenia. Cardiotoxicity was not observed.
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