CIS-DICHLORODIAMMINEPLATINUM(II), METHOTREXATE, BLEOMYCIN, AND VINCRISTINE IN HEAD AND NECK-CANCER - PILOT-STUDY

Abstract

Patients (39) with advanced epidermoid carcinoma of the head and neck were treated with a combination of cis-dichlorodiammineplatinum(II), methotrexate, bleomycin and vincristine. Patients (29) were evaluable for response and 39 were evaluable for toxicity. With this regimen toxicity was acceptable and the following rates were observed in a total of 139 treatment courses: 100% (nausea and vomiting), 3% (decreased creatinine clearance), 4% (thrombocytopenia), 5% (leukopenia), and 2% (pulmonary fibrosis). There was 1 death due to sepsis during a period of chemotherapy-induced leukopenia. Although the patients treated with this regimen had advanced disease and were treated aggressively previously, an overall response rate of 24% was observed, with 3 patients (10%) having a complete response. Median duration of response was 7 + mo. This intensive combination chemotherapy apparently has a sufficiently favorable risk/benefit ratio to allow its evaluation in randomized clinical trials in the treatment of patients with head and neck cancer.