Comparative study of two neoadjuvant protocols (VBM and DDP-BLM) combined with radiation therapy in advanced head and...

Forty-five patients with epidermoid cancer of the head and neck were either treated with cisplatin and bleomycin (DDP-BLM) or with vincristine, bleomycin and methotrexate (VBM) as neoadjuvant chemotherapy before radical radiation therapy (XRT). Chemotherapy with DDP-BLM provided a tumoral response of 80% [20% complete response (CR), 60% partial response (PR)]; VBM showed a response of 60% (12% CR, 48% PR). At the end of XRT-program (65 Gy total dose, 2-2.5 Gy dose per fraction, 5 times a week) complete response rates were similar in VBM-pretreated group (52.5%) and DDP-BLM pretreated group (50%). Analysis of survival shows no significant difference between the two inductive schemes: 8% vs 7.5% at 72 months. Our study suggests an increased initial response rate but no advantage in survival with combined therapy in comparison with standard XRT: long-term benefits were not apparent in these two groups of patients.