Preoperative chemo-radiotherapy in advanced head and neck cancer.
In a prospective evaluation, two preoperative courses of methotrexate, bleomycin, and cisplatin combined with 2,000 rad/10 fractions ("chemo-radiotherapy") yielded 78% responses rates in previously untreated advanced head and neck cancer. Similarly staged patients receiving preoperative irradiation of 5,000 rad alone had a 67% response rate. Treatment-related mortality in the chemo-radiotherapy patients was equal to that seen with standard combinations of surgery and preoperative or postoperative irradiation. At 24 months, disease-free survival is 47% with chemo-radiotherapy vs 33% with standard therapy; however, patients benefiting most from the former approach were those with T4 primary lesions or N3a neck nodes.
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D011897:Random Allocation
D000970:Antineoplastic Agents; D001761:Bleomycin; D002945:Cisplatin; D008727:Methotrexate