Journal of Clinical Oncology, Vol 1, 421-427, Copyright © 1983 by American Society of Clinical Oncology
Cisplatin-vincristine-bleomycin therapy in squamous cell carcinoma of the head and neck
PC Amrein, H Fingert and SA Weitzman
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.
