Concurrent chemotherapy and radiation therapy in advanced head and neck cancer

A combination of radiation therapy and cis-platinum (25 mg/m2 i.v.) day 1, vincristine (1 mg i.v.) day 2, and bleomycin (15 U i.v.) day 4 was given concomitantly to 14 patients with advanced inoperable head and neck cancer and one patient with local recurrence. Radiation therapy consisted of 70 Gy to the involved areas and 50 Gy to adjacent uninvolved areas at 1.8 Gy per fraction. The overall response rate was 100%. Nine patients (60%) achieved a complete response, and six patients achieved a partial response. One patient appeared to have increasing disease, but biopsies have shown only fibrosis. The survival is 8 of 15 (53%), with a median follow-up time of 24 months. Most significant toxicity was anorexia and weight loss. Other toxicity consisted of peripheral neuropathy (1 patient), mild transient elevation of creatinine (1 patient), hypothyroidism (1 patient), and mild pulmonary toxicity (2 patients). Mucositis occurred in all patients, requiring interruption of therapy (2-14 days).