[Results of a multidisciplinary treatment protocol for advanced squamous cell carcinoma in the ORL region]

49 previously untreated patients with advanced stage III or IV epidermoid cancer of the head and neck were included in a controlled study. Prior to and after radiotherapy or surgery, 41 patients received regimen I with platinum and bleomycin, 8 patients in regimen II were treated with bleomycin, cyclophosphamide, methotrexate and 5-fluorouracil. After initial chemotherapy and radiotherapy (2000 rad) 31 patients (76%) in regimen I and all patients in regimen II showed an objective complete or partial response. At the end of radiotherapy or surgery 37 of 49 (75%) patients achieved complete tumour clearance. The median follow-up in our study is 17 months and the median survival 22 months (preliminary results). The combined modality approach demonstrated substantial antitumour activity, but we will have to await the results of randomized studies to assess the value of adjuvant chemotherapy in advanced head and neck cancer.