Combined chemotherapy of head and neck squamous cell carcinomas with methotrexate, bleomycin, and hydroxyurea

Medenica, R; Alberto, P.; Lehmann, Willy

doi:10.1007/bf00258471

Cited by 11 publications

(1 citation statement)

References 3 publications

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“…On the basis of Norton's original concept, in 1997 we initiated a sequential chemotherapy induction as a part of a multimodality approach in patients with locally advanced SCCHN amenable to surgery. This feasibility study used the classical active compounds available at that period for SCCHN 16, 17. Treatment consisted of a dose‐dense combination of three cycles of cisplatin/5‐fluorouracil followed by two cycles of bleomycin/methotrexate/hydroxyurea.…”

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Preoperative sequential chemotherapy in locally advanced squamous cell carcinoma of the head and neck

et al. 2005

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Preoperative sequential chemotherapy in locally advanced squamous cell carcinoma of the head and neck

et al. 2005

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Cis-platinum induction chemotherapy in the multi-modality initial treatment of advanced stage IV carcinoma of the head and neck

Schaefer

Middleton

Reisch

1983

Cancer

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Twenty‐eight previously untreated patients with unresectable and radical radiotherapy incurable advanced stage IV squamous cell carcinoma of the head and neck underwent cis‐diamminedichloroplatinum (DDP) induction chemotherapy followed by radiation with 6500 rad to the primary and 5000 rad to the supraclavicular area given over six weeks. Of the 26 patients completing this regimen, none had a complete remission after DDP alone. Following radiation therapy, 39% of the patients had a total regression of all disease. This modality converted 16 patients to operable candidates. After surgery, 68% of the patients were in complete remission. Survival was significantly correlated (P ≤ 0.001) with complete disappearance of disease, and surgical intervention was additive to chemotherapy and radiation. Histopathologic staging demonstrated that clinical assessment of residual disease in the neck determined after chemotherapy and radiation of the neck was unreliable. Therefore, radical neck dissection appears indicated in lesions initially staged as N2 and N3 irrespective of the postradiation clinical status of the neck region. Finally, a serious limitation of improved survival duration was the occurrence of disseminated disease in patients whose primary and regional lesions were well controlled.

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The impact of combined therapeutic modalities in head, neck, and esophageal cancer

Desai

Waś

et al. 1985

Seminars in Surgical Oncology

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Nearly 50% of head and neck cancers and two-thirds of patients with esophageal cancer generally present late for initial treatment. The patterns of failure are generally locoregional with around 10% showing distant dissemination. Surgery alone and in combination with pre-operative radiation has not significantly increased salvage in these groups of cancer. The availability of increasingly effective drugs (Cisplatinum, MTX., Bleomycin), for head, neck and esophageal cancers have produced dramatic initial responses with excellent palliative relief of symptoms enabling adequate definitive radiotherapy or surgery for advanced T3, T4 lesions. Cisplatinum 20 mg/m2 daily X 5 - twice at the interval of 10 days with MTX 25 mg/m2 and Bleomycin 15 mg/m2 weekly X 2 have been used for T3 and T4 Head and Neck Cancers and Cisplatinum in the same dosage and MTX 200 mg twice in 10 days have been used for esophageal cancers. 88% responses in 35 patients have been noted in head and neck cancers and when the chemotherapy was followed by definitive radiotherapy, complete responses were achieved in 16 out of 25 patients (64%). This is a very significant response rate for T3, T4 cancers. Patients who were in a reasonably acceptable general condition after this regimen were further considered for two more courses of consolidative chemotherapy. Response rates in esophageal cancer was 78% (26 of 34 evaluable patients) - 6 of the 26 showed a complete response and all are alive from 8 months to 26 months. Our failure to obtain increasing cures at 3 and 5 years may be due to our ignorance of the capacity of dormant cells to proliferate, tumor cell kinetics, more effective use of chemotherapy or the biology of the host. These areas need further investigation.

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Combined chemotherapy of head and neck squamous cell carcinomas with methotrexate, bleomycin, and hydroxyurea

Cited by 11 publications

References 3 publications

Preoperative sequential chemotherapy in locally advanced squamous cell carcinoma of the head and neck

Preoperative sequential chemotherapy in locally advanced squamous cell carcinoma of the head and neck

Cis-platinum induction chemotherapy in the multi-modality initial treatment of advanced stage IV carcinoma of the head and neck

The impact of combined therapeutic modalities in head, neck, and esophageal cancer

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