Vinblastine, methotrexate, bleomycin, in the management of head and neck cancer

• Published in: European journal of cancer Vol. 15; no. 11; pp. 1315 - 1318
• Main Authors: Vanhaelen, C., Bertrand, M., De Jager, R., Kenis, Y.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.1979
• Subjects: Antineoplastic Agents - therapeutic use; Bleomycin - therapeutic use; Carcinoma, Squamous Cell - drug therapy; Clinical Trials as Topic; Dose-Response Relationship, Drug; Drug Therapy, Combination; Head and Neck Neoplasms - drug therapy; Humans; Leukopenia - chemically induced; Methotrexate - therapeutic use; Thrombocytopenia - chemically induced; Vinblastine - therapeutic use
• ISSN: 0014-2964
• DOI: 10.1016/0014-2964(79)90107-5

Fourty-three patients with head and neck epidermoid carcinomas were treated with combination chemotherapy consisting of vinblastine (VLB) 4 mg/m 2 i.v., methotrexate (MTX) 60 mg/m 2 i.v. and bleomycin (BLM) 15 mg i.v. day 1 and 8, q 28 days. Dose limiting toxicity was clearly hematological: leukopenia was more severe than thrombopenia and 5 patients died of septicemia associated with WBC < 1000. Other toxicities included mucositis, skin rash, fever, nausea and vomiting. Alopecia was rare. Treatment was stopped in two patients because of reversible pulmonary toxicity. There was no significant hepatic or renal toxicity. Ten patients were inevaluable: because of loss of follow-up or refusal of treatment ( 9) or intercurrent radiation therapy ( 1). Out of 33 fully evaluable patients, there were 9 ( 27%) responders: 3 complete responses lasting 8, 16+, 18+ months and 6 partial responses (> 50% decrease in tumor size) for a median duration of 4 months. Stabilisation of disease (no change or regression <50%) was seen in 8 ( 23%), progression of disease in 8 ( 23%), early death in 3 ( 9%) and toxic death in 5 ( 15%) patients. Although some long lasting complete remissions were seen in head and neck cancer patients treated with this regimen, it appears too toxic to be recommended.