Safe and effective combination chemotherapy without cis-platinum for squamous cell carcinomas of the head and neck

Different combinations of "standard" antitumor drugs were given to patients with squamous cell carcinomas of the head and neck. One hundred fifty-five patients received a combination of vincristine, bleomycin, methotrexate, hydrocortisone, and 5-fluorouracil given over 24 hours every 2 to 3 weeks. In patients who had received no previous treatment, 57 of 76 assessable patients (75%) responded. In previously treated patients, 20 of 40 assessable patients responded (50%). Prior radiation significantly reduced response to chemotherapy. A response to initial chemotherapy increases the likelihood of successful local treatment. In this study, response to drug treatment was not affected by age, sex, histology, or site. Crude survival at 2 years is significantly increased in responding patients compared with a historically matched control group when chemotherapy is given before radiation therapy or surgery. Preliminary results of a randomized prospective controlled study suggest that primary adjuvant chemotherapy without cis-platinum may significantly increase survival in this group of patients.