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A Preliminary Report of Neoadjuvant Chemotherapy With Cisplatin, Bleomycin, and Methotrexate

Thomas J. Ervin, MD; Ralph R. Weichselbaum, MD; Richard L. Fabian, MD; Daniel Miller, MD; Carl M. Norris, Jr, MD; Marshall R. Posner, MD; Christopher Rose, MD; Peter Lockhart, DDS; Stephanie A. Tuttle, MS; John M. MacIntyre, PhD; Emil Frei, III, MD

Arch Otolaryngol. 1984;110(4):241-245.

Abstract
• Between Oct 1, 1979 and Aug 1, 1982, 93 patients with advanced squamous carcinoma of the head and neck were given neoadjuvant treatment with cisplatin, bleomycin sulfate, and methotrexate before standard local treatment. Ninety-three patients were evaluable for response. The response rates were as follows: complete response, 24%; partial response, 64%; and no response, 12%. Differences in primary tumor site, performance status at presentation, histologic grade, and tumor size did not correlate with response to this chemotherapy. For patients achieving notable tumor reduction to 2 cm or less, standard local treatment with either surgery plus radiotherapy or high-dose radiotherapy alone was effective in controlling local disease. For patients with larger tumor masses following neoadjuvant chemotherapy, surgical resectability appeared to improve local control rates. In our series, patients not receiving maximal standard local treatment often had relapse of local disease despite favorable responses to chemotherapy.

(Arch Otolaryngol 1984;110:241-245)

Author Affiliations
From the Divisions of Medicine (Drs Ervin, Fabian, Miller, Norris, Posner, and Frei and Ms Tuttle) and Biostatistics (Dr MacIntyre), Dana-Farber Cancer Institute; the Joint Center for Radiation Therapy (Drs Weichselbaum and Rose); and Brigham and Women's Hospital (Dr Lockhart), Harvard Medical School, Boston.

Footnotes
Accepted for publication Sept 14, 1983.

Reprints not available.

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