Seventy-two patients with advanced resectable head and cancer received two courses of induction chemotherapy before definitive therapy. Forty-six patients were treated with platinol, Oncovin (vincristine), and bleomycin. Twenty-six received Platinol (cisplatin), Velban (vinblastine), and 5-fluorouracil (5-FU). Although both regimens had an overall response rate of 80% or more, the bleomycin-containing regimen had a higher complete response rate and better long-term disease control, with >60% probability of remaining disease-free (36 month minimum follow-up). As given in this regimen, the 5-FU regimen was well tolerated but had a higher incidence of stomatitis and a low rate of complete responses. When the two regimens were compared to a historical control, the regimen with Platinol, Oncovin, and bleomycin was significantly better.
Cancer 57: 1 1 10-1 1 14, 1 986.
NLIKE the situation with many other solid tumors, U there are a variety of chemotherapeutic agents which demonstrate significant activity in both treated and untreated squamous cell carcinoma of the head and neck.' Because of the unacceptable cure rate for advanced head and neck cancer when treated with surgery and/or radiation, a number of combined modality programs have been piloted in which chemotherapy is an important part of the primary treatment plan. In the majority of these, chemotherapy is administered before surgery or radiation therapy. The very high tumor response rate, the tolerance of such patients to chemotherapy, and their ability to complete definite therapy has been well established in these studies. Little data is available in a comparative trial or with good historical controls to show the benefit of one study versus another, however.
In 1978, we began a pilot study of induction chemotherapy in patients with advanced resectable squamous cell carcinoma from the head and neck. We initially used an induction regimen which included Platinol (cisplatin), Oncovin (vincristine), and Blenoxan (bleomycin), treating 46 patients with these drugs prior to definitive therapy. In 198 I , we began a new study with Platinol, Velban (vinblastine), and 5-fluorouracil (5-FU), administering two courses of this combination before definitive therapy.