B-CMF                                               head_neck(64)
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  bleomycin....... 30 U continuous IV over days 1 to 4.
  cytoxan......... 200 mg/sqm/day IV on days 1 to 5.
  methotrexate.... 20 mg/sqm IV on days 1 and 5.
  fluorouracil.... 400 mg/sqm/day IV on days 1 to 5.
  FREQUENCY....... Repeat cycle every 22 to 28 days, on return of 
                   WBC count to normal.


  reference...
    Holoye PY.  Byers RM.  Gard DA.  Goepfert H.  Guillamondegui 
    OM.  Jesse RH. Combination chemotherapy of head and neck 
    cancer. Cancer.  42(4):1661-9, 1978 Oct. 
  abstract...
    A total of 77 patients with cancer of the head and neck area 
    were treated with five different drug combination regimens. 
    Five of the 77 patients had lymphoepithelioma; four had 
    adenocystic carcinoma, and 68 had squamous-cell carcinoma of 
    the head and neck (16 from the skin). Of these 77 patients, 16 
    had no previous treatment, five had surgery, 11 had 
    radiotherapy, and 45 had surgery and radiotherapy. The first 
    regimen consisted of a four-day Bleomycin infusion followed 
    after a 24-hour rest, by cyclophosphamide (Cytoxan), 
    Vincristine (Oncovin), methotrexate and 5-Fluorouracil (5-FU) 
    (B-COMF). The next three regimens consisted of a four-day 
    Bleomycin course, followed by either Cytoxan and methotrexate 
    (B-CM), Cytoxan and 5-FU (B-CF) or Methotrexate and 5-FU 
    (B-MF). The fifth regimen consisted of Bleomycin concomitant 
    with Cytoxan, Methotrexate, and 5-FU (B-CMF). Of the 49 
    patients receiving B-COMF and B-CMF, 12 showed a complete 
    response and 12 a partial response. Among the 28 patients 
    receiving Bleomycin, followed by any one of the two drug 
    regimens, only six showed a partial response. The severity of 
    the thrombocytopenia, number of drugs, lymphoepithelioma 
    histology and performance status of the patient influenced the 
    rate of response. Drug toxicity consisted mostly in 
    myelosuppression. The B-CMF combination is highly effective 
    and can be used as an adjuvant to surgery and/or radiotherapy.