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.
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.
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.