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Cancer Chemotherapy Regimen for Head and Neck Cancer


 CBM                                                 head_neck(68)
 _________________________________________________________________
  cisplatin....... 20 mg/sqm/day IV on days 1 to 5.
  bleomycin....... 2.5 U/sqm/day: IV day 1 and IM on days 2 to 5. 
  mitomycin....... 6 mg/sqm IV day 1.
  FREQUENCY....... Repeat cycle every 3 weeks.

  reference...
    Israel L.  Aguilera J.  Soudant J.  Penot JC.  Breau JL.  
    Morere JF. Bleomycin and cis-platinum with or without 
    mitomycin C in 110 previously untreated patients with head and 
    neck cancer. American Journal of Clinical Oncology.  
    6(3):305-11, 1983 Jun. 
  abstract...
    Between November 1979 and October 1981, 110 consecutive 
    patients with previously untreated, biopsy-proven squamous 
    cell carcinoma of the head and neck, were treated by 
    chemotherapy prior to scheduled surgery and/or radiotherapy. 
    Two regimens of chemotherapy were used. The first 57 patients 
    received cis-platinum, 20 mg/m2/day for 5 consecutive days and 
    bleomycin 5 mg/m2/day as a continuous infusion over the same 5 
    days every 3 weeks (Regimen A). The next 53 patients received 
    the same schedule and dose of cis-platinum, bleomycin 2.5 
    mg/m2 every 12 hours for the same 5 consecutive days and 
    mitomycin C6 mg/m2 on day 1 of each cycle every 3 weeks 
    (Regimen B). The number of courses administered prior to 
    surgery and/or radiotherapy ranged from 1-4 depending on the 
    otorhinolaryngologist's assessment of the optimal time for 
    locoregional treatment. The overall response rate in regimen A 
    was 78% (45/57) compared to 90% for regimen B (48/53). 
    Complete responses were seen in 10/57 (18%) and 13/53 (25%) 
    patients in regimens A and B, respectively. Eight of 57 
    patients in regimen A and 6/53 in regimen B refused further 
    treatment and follow-up, and 7/53 patients in regimen B chose 
    to pursue chemotherapy (in which methotrexate replaced 
    bleomycin) rather than undergo surgery and/or radiotherapy. 
    Five of these seven patients are surviving disease-free from 
    7-12 months. In regimen A, 31/57 patients are surviving with a 
    median survival exceeding 15 months. In regimen B, 46/53 
    patients are surviving up to 14 months. Nausea and vomiting 
    induced by cis-platinum were the major side effects, seen to a 
    variable degree in all patients. No cis-platinum-induced renal 
    toxicity was observed with the 5-day regimen and none of the 
    patients had symptomatic bleomycin-induced pneumonitis. One 
    patient had a bleomycin-induced skin rash which did not 
    require discontinuation of therapy. 
 

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