Preirradiation chemotherapy for advanced head and neck carcinomas

Twenty-six patients with locally advanced squamous cell carcinoma of the head and neck region were treated with combination chemotherapy (cisplatin, bleomycin sulfate, and vincristine sulfate) prior to radiotherapy (RT). The chemotherapy produced a 65% major response rate, all partial responses. Significant hematologic toxic effects occurred in only two patients and severe renal toxic effects were not seen. Concurrently, 20 additional patients with locally advanced cancers were treated with high-dose RT along. Weight loss at the completion of RT and normal tissue reactions were similar in both groups. Complete tumor resolution occurred in 45% of RT-alone patients and 42% of patients completing combined-modality therapy. No difference in recurrence-free survival was seen. Despite minimal additional morbidity and a high response rate, this preirradiation chemotherapy regimen demonstrated no major impact on complete response rate or on long-term recurrence-free survival.