Bleomycin and cis-platinum with or without mitomycin C in 110 previously untreated patients with head and neck cancer

• Published in: American journal of clinical oncology Vol. 6; no. 3; p. 305
• Main Authors: Israel, L, Aguilera, J, Soudant, J, Penot, J C, Breau, J L, Morere, J F
• Format: Journal Article
• Language: English
• Published: United States 01.06.1983
• Subjects: Adult; Aged; Antibiotics, Antineoplastic - administration & dosage; Antibiotics, Antineoplastic - therapeutic use; Bleomycin - administration & dosage; Bleomycin - therapeutic use; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Cisplatin - administration & dosage; Cisplatin - therapeutic use; Drug Administration Schedule; Drug Evaluation; Drug Therapy, Combination; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - mortality; Humans; Middle Aged; Mitomycin; Mitomycins - administration & dosage; Mitomycins - therapeutic use
• ISSN: 0277-3732
• DOI: 10.1097/00000421-198306000-00009

Between November 1979 and October 1981, 110 consecutive patients with previously untreated, biopsy-proven squamous cell carcinoma of the head and neck, were treated by chemotherapy prior to scheduled surgery and/or radiotherapy. Two regimens of chemotherapy were used. The first 57 patients received cis-platinum, 20 mg/m2/day for 5 consecutive days and bleomycin 5 mg/m2/day as a continuous infusion over the same 5 days every 3 weeks (Regimen A). The next 53 patients received the same schedule and dose of cis-platinum, bleomycin 2.5 mg/m2 every 12 hours for the same 5 consecutive days and mitomycin C6 mg/m2 on day 1 of each cycle every 3 weeks (Regimen B). The number of courses administered prior to surgery and/or radiotherapy ranged from 1-4 depending on the otorhinolaryngologist's assessment of the optimal time for locoregional treatment. The overall response rate in regimen A was 78% (45/57) compared to 90% for regimen B (48/53). Complete responses were seen in 10/57 (18%) and 13/53 (25%) patients in regimens A and B, respectively. Eight of 57 patients in regimen A and 6/53 in regimen B refused further treatment and follow-up, and 7/53 patients in regimen B chose to pursue chemotherapy (in which methotrexate replaced bleomycin) rather than undergo surgery and/or radiotherapy. Five of these seven patients are surviving disease-free from 7-12 months. In regimen A, 31/57 patients are surviving with a median survival exceeding 15 months. In regimen B, 46/53 patients are surviving up to 14 months. Nausea and vomiting induced by cis-platinum were the major side effects, seen to a variable degree in all patients. No cis-platinum-induced renal toxicity was observed with the 5-day regimen and none of the patients had symptomatic bleomycin-induced pneumonitis. One patient had a bleomycin-induced skin rash which did not require discontinuation of therapy.