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Cancer Chemotherapy Regimen for Head and Neck Cancer


 VBC                                                 head_neck(72)
 _________________________________________________________________
  vinblastine..... 4 mg/sqm IV day 1.
  bleomycin....... 15 U/day IM on days 1 to 7.
  cisplatin....... 60 mg/sqm IV day 8.
  FREQUENCY....... Repeat cycle every 3 weeks for  3 cycles.


  reference...
    Brown AW Jr.  Blom J.  Butler WM.  Garcia-Guerrero G. 
    Richardson MF.  Henderson RL. Combination chemotherapy with 
    vinblastine, bleomycin, and cis-diamminedichloroplatinum (II) 
    in squamous cell carcinoma of the head and neck. Cancer.  
    45(11):2830-5, 1980 Jun 1. 
  abstract...
    Forty-five patients with advanced squamous cell carcinoma of 
    the head and neck, 23 of whom had received no prior therapy, 
    were given the combination of vinblastine, 4 mg/m2 
    intravenously (IV) on Day 1; bleomycin, 15 mg/day 
    intramuscularly on Days 1-7; and cis-diamminedichloroplatinum 
    (II), 60 mg/m2 with mannitol diuresis on Day 8. The regimen 
    was repeated at three-week intervals, for a maximum of three 
    cycles. Among the 23 patients without prior surgery or 
    radiation, there were 5 complete responses and 12 partial 
    responses, a 74% response rate; whereas, among the 22 with 
    prior therapy, there were 2 complete responses and 8 partial 
    responses, a response rate of 45%. Nineteen of 23 previously 
    untreated patients were subsequently given radiation, 1 had 
    surgery, and 1 had surgery plus radiation. Twelve of these 19 
    patients are currently free of disease, with a median duration 
    of ten months from initial response. Four of the 22 previously 
    treated patients received radiation and 2, surgery; 4 of these 
    6 patients are without evidence of disease. Renal dysfunction 
    with elevation of serum creatinine occurred in 5 patients, a 
    leukocyte count of less than 3,000/mm3 in 3, a platelet count 
    of less than 100,000/mm3 in 2, skin changes in 11, hearing 
    loss in 1, and both peripheral neuropathy and pulmonary 
    changes in 1 patient. This combination of agents has 
    substantial activity in untreated patients and may be useful 
    as initial therapy in advanced head and neck malignancies by 
    diminishing the incidence of local recurrence and distant 
    metastasis. 
 

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