Cancer Chemotherapy Regimen for Head and Neck Cancer
B-CMF head_neck(64) _________________________________________________________________ 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.
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