TREATMENT OF ADVANCED SQUAMOUS-CELL CARCINOMA OF THE HEAD AND NECK WITH CISPLATIN, BLEOMYCIN, AND METHOTREXATE (PBM)

Abstract

Of 32 patients with advanced squamous cell carcinoma of the head and neck 29 were treated with 2 courses of an intensive chemotherapy regimen consisting of cisplatin, bleomycin and methotrexate (PBM). The frequency of toxic effects (in 29 evaluable patients) associated with this regimen was low. Serious neutropenia occurred in 17% and thrombocytopenia in 10% of the courses. Nausea (50%) and severe vomiting (6%) were easily managed. All 26 (100%) evaluable patients with squamous cell carcinoma had significant reduction (> 50%) of measurable tumor. Complete regression was noted in 7 patients (27%). Fifteen patients were treated with PBM prior to receiving radiation therapy or surgery as definitive treatment for their disease. Antitumor response in these patients was rapid, occurring within 3 wk from the initiation of chemotherapy. Maximal antitumor effect was achieved by wk 6 of induction chemotherapy. No patient showed tumor regrowth prior to the institution of radiation therapy or surgery. Twelve patients with recurrent disease following previous radiotherapy and/or surgery also received PBM chemotherapy. Previous radiotherapy or surgery did not diminish the antitumor effect of PBM, but toxicity was more severe.