[Neo-adjuvant chemotherapy of head and neck cancer]

Pre-operative chemotherapy with vincristine, moderately high doses of methotrexate plus "rescue", and bleomycin for six weeks was administered to 26 patients with untreated carcinoma of the head and neck. Treatment was well tolerated and compliance was very good. Objective side effects necessitated ending treatment in ten patients. Tumour regression of over 50% (responders with partial or complete remission) was recorded in 17 patients; five of them had no histological evidence of tumour in the surgical specimen. In three patients the tumour regressed slightly, in two it remained unchanged and in four it had progressed at the end of treatment (nine non-responders). After a minimum observation period of 36 months 12 of the 26 patients were still alive. Median survival time had not yet been reached in the 17 responders. But the median survival time of the non-responders was 15 months. It is concluded that this form of treatment is very effective and well tolerated. If response is achieved it opens the prospect of prolonged survival time.