Polychemotherapy in squamous cell carcinoma of the buccal mucosa

Thirty-nine patients with previously untreated squamous cell carcinoma of the buccal mucosa were treated by two polychemotherapeutic regimens. The first regimen consisted of bleomycin and methotrexate (BLM-MTX): bleomycin 30 mg was given intravenously twice weekly, and methotrexate 25 mg intravenously twice weekly for 2 1/2 and two weeks, respectively. The second program consisted of Cytoxan (cyclophosphamide), methotrexate and 5-FU (CMF): methotrexate 25 mg twice weekly for two weeks, Cytoxan 100 mg/day for two weeks, and 5-FU 500 mg twice weekly for 1 1/2 weeks. All of the patients were evaluated one week after completion of their chemotherapy regimen. Although the patients were not randomly allocated to either treatment, they matched in age and extent of disease. High response rates (88.9%) were noted with the BLM-MTX combination, which is comparable to the best responses reported previously using cis-platinum, Oncovin (vincristine), and methotrexate. This may suggest that buccal cancers are highly sensitive to an initial treatment by BLM-MTX, and therefore the authors highly recommend its use as preoperative adjuvant therapy in patients who present with Stage III and IV (Mo) disease.