Multidrug chemotherapy using bleomycin, methotrexate, and cisplatin combined with radical radiotherapy in advanced head and neck cancer.
Thirty-one patients with Stage III-IV head and neck squamous cell cancer were treated by three courses of combination chemotherapy using bleomycin, methotrexate, and cisplatin followed by a radical course of radiation and in two cases by surgery. Of 29 evaluable patients, 4 (14%) achieved complete remission (CR) with chemotherapy and 13 (45%) had a partial response (PR). With the addition of radiotherapy and surgery, the CR rate increased to 72%. At 30 months the actuarial survival of all evaluable patients was 61% and of complete responders, 76%. Patients with nasopharyngeal cancer had an actuarial survival of 80% at 30 months, whereas patients with squamous malignancies at other sites in the head and neck region had an actuarial survival of only 37%. Side effects were tolerable. It is concluded that complete responders to combination chemotherapy and radiotherapy have a survival benefit at 30 months. The combined approach is most effective in nasopharyngeal cancer.
D000206:Actuarial Analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy
D001761:Bleomycin; D002945:Cisplatin; D008727:Methotrexate