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.
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.
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.