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Induction chemotherapy in advanced squamous head and neck carcinoma with high‐dose cis‐platinum and bleomycin infusion
Author(s) -
Hong Waun Ki,
Shapshay Stanley M.,
Bhutani Rakesh,
Craft Melody L.,
Ucmakli Alptekin,
Yamaguchi Kent T.,
Vaughan Charles W.,
Stuart Strong M.
Publication year - 1979
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197907)44:1<19::aid-cncr2820440104>3.0.co;2-r
Subject(s) - medicine , mucositis , surgery , bleomycin , chemotherapy , nephrotoxicity , rash , vomiting , wound dehiscence , anesthesia , urology , gastroenterology , toxicity
Forty patients with advanced head and neck cancer were treated with combined Cis‐platinum‐Bleomycin chemotherapy. Cis‐diammine dichloroplatinum (DDP) 120 mg/m 2 iv was given after prehydration, with mannitol diuresis on Day 1. On Day 3, an initial loading dose of Bleomycin 15 mg/m 2 was given by rapid iv push followed by continuous 24 hour intravenous infusion of Bleomycin 15 mg/m 2 Day 3 through Day 10. DDP 120 mg/m 2 iv was administered again on Day 22. The patients were evaluated for tumor response and resectability between Day 29 to Day 35. Of 39 patients who were evaluable, there were 8 complete responses or CR (20%) and 22 partial responses or PR (56%), for a major response rate of 76%. Nineteen patients had surgery (14 patients whose lesions were initially inoperable and 5 patients who were initially operable). Chemotherapy toxicity in 40 patients included alopecia (40), vomiting (39), mucositis (11), skin rash (10), fever (17), weight loss of more than 5 lbs. (25), WBC less than 3,000 (2), platelets less than 100,000 (1), peak serum creatinine of 2 mg% (3), severe‐hearing loss (1), hypersensitivity reaction (2). Surgical complication in 19 patients were pharyngocutaneous fistulae (2), wound dehiscence (1), meningitis and brain abscess (1). There was one death secondary to nephrotoxicity. This particular combination chemotherapy when given as initial treatment, appears very effective in reduction of tumor bulk. Long‐term follow‐up and randomization is necessary to determine effect upon survival.