Treatment of advanced squamous cell carcinoma of the skin with cisplatin, 5-fluorouracil, and bleomycin

Abstract

The authors treated 14 patients with advanced squamous cell carcinoma (SCC) of the skin or lip with one to four cycles of combination chemotherapy consisting of cisplatin by bolus injection, and 5-fluorouracil (5-FU) and bleomycin by continuous 5-day infusion. Objective responses were seen in 11 of the 13 evaluable patients (84%). Four patients had a complete remission (30%) and seven patients, a partial remission (54%). Local control after definitive complementary radiation and/or surgical treatment was achieved in seven patients. Toxic side effects was acceptable; they consisted of nausea and vomiting in all patients, transient skin changes, hematologic (Grade 3/4) abnormalities in four patients, and pulmonary fibrosis in one elderly patient. These results show that this chemotherapy combination could play a role in reducing the tumor mass and in facilitating definitive treatment to obtain better functional and cosmetic results in advanced SCC of the skin.

High-risk Cutaneous Squamous Cell Carcinoma

“…Experimental trial of cisplatin in combination with bleomycin and 5-fluorouracil to produce tumor regression permitting surgery has been reported in 11 patients. 82 Results from randomized trials comparing chemotherapy vs adjuvant RT alone in high-risk cSCC are awaited. Further prospective clinical trials are also required to clarify the role of chemotherapy in highrisk cSCC.…”

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

“…[654][655][656][657][658] These were generally small case series with only a small number of patients with eligible SCCs, or case reports, and are summarised in Table 57. In all of the studies definitive initial treatment with surgery or radiotherapy was not possible.…”

“…655 Of three patients with SCCs of disfiguring size who were treated with neoadjuvant chemotherapy prior to surgery, complete response was seen in two patients, although one of them had a local recurrence of tumour after 8 months, and no response was seen in one patient who died from their disease 10 months after treatment. 656 No recurrences or metastasis were reported in the remaining studies, although these were all single case reports. 654,657,658 All of the studies reported adverse events related to chemotherapy.…”

“…Two treatment related deaths were reported: one of 15 patients had multiorgan failure after hyperthermic isolated limb perfusion 655 and one of 14 died from a pulmonary infection superimposed on lung fibrosis following neoadjuvant chemotherapy. 656 …”

Advanced Squamous Cell Carcinoma of the Skin

“…Sadek et al reported on the treatment of 14 patients with advanced squamous cell carcinoma of the skin or lip with a combination of bolus cisplatin, plus a five-day infusion of bleomycin and 5-fluorouracil. (Sadek, Azli et al 1990) Four complete and seven partial responses were observed and in seven patients, tumor regression permitted subsequent definitive local treatment with either surgery or radiation therapy.…”