title: Cisplatin-vincristine-bleomycin therapy in squamous cell carcinoma of the head and neck.
abstract: Seventy patients with squamous cell carcinoma of the head and neck were treated with a 24-hour infusion of cisplatin, followed by vincristine and bleomycin. Among 37 patients with no prior treatment who had stage III (2) or stage IV (35) disease, there were 2 complete responders and 23 with a partial response, for an overall response frequency of 67%. Among 27 patients with recurrent disease after radiotherapy and/or surgery, there were 9 (33%) partial responses. Among 6 patients having failed prior chemotherapy, there was 1 complete responder, still in remission at 26 months. Response frequency was highly dependent on performance status and stage of disease, with a response of 80% in the 0 performance status group and 83% for stages less than T4N3M0. Among 18 patients with resectable disease, 51% remain disease-free at 12 months with an overall median survival at 16 months. Among the 33 patients with recurrent disease, the median duration of response and survival was 4 and 12 months for responders, respectively; nonresponders had a median survival of 5 months. The toxicity of this regimen was generally mild, with 21% of patients having no vomiting and 91% never having a serum creatinine over 2.0 mg/dL. There were 2 cases of pulmonary fibrosis. This chemotherapy regimen compares favorably with other published regimens for head and neck cancer with respect to activity and may be less toxic.
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D001761:Bleomycin; D014750:Vincristine; D002945:Cisplatin