Bleomycin as adjuvant in radiation therapy of advanced squamous cell carcinoma in head and neck

Since 1969, Bleomycin (BLM) has been used in three different ways at the Radium Centre in Copenhagen. First BLM given as the sole treatment led to complete regressions in 12% of 138 patients (12). Secondly BLM was used as simultaneous adjuvant in radiation therapy for 86 previously untreated patients, but 66% developed mucositis which disrupted the treatment. In a third period BLM was therefore combined sequentially with radiation, administered for 2 weeks prior to radiation therapy to 142 patients. The tumour shrinkage achieved with preirradiation BLM was very pronounced in 38% of cases. 104 patients with T3 tumours have been observed for a minimum of 3 years. The medium survival time, 47 months for those sequentially treated patients responding pronouncedly to BLM, was greater than for the remainder of the sequentially treated patients, 16 months (2 p = 0.010) and for the patients treated simultaneously with BLM, 15 months (2 p = 0.013). The prognostic value of the degree of shrinkage achieved with preirradiation BLM treatment is discussed.