Effective outpatient combination chemotherapy for advanced cancer of the head and neck

Forty-six patients with advanced cancer of the head and neck, 42 of whom had failed conventional radiotherapy or surgical excision, or both, were treated on an outpatient basis with a regimen consisting of bleomycin, methotrexate and cis-diamminedichloroplatinum II. Objective responses were noted in 29 patients, with eight having apparent complete remissions. The median duration of partial response was only five months, but the median duration of complete remission was 11 months. Median survival time for nonresponders was four months, for partial responders, six months, and for complete responders, 20 months. Toxicity was acceptable. This regimen can be safely and conveniently used prior to radical excision or irradiation. The results in patients who failed to respond to prior therapy appear substantially superior to those achieved with methotrexate alone.