Cisplatin-vincristine-bleomycin therapy in squamous cell carcinoma of the head and neck

Seventy patients with squamous cell carcinoma of the head and neck were treated with a 24-hour infusion of cisplatin, followed by vincristine and bleomycin. Among 37 patients with no prior treatment who had stage III (2) or stage IV (35) disease, there were 2 complete responders and 23 with a partial response, for an overall response frequency of 67%. Among 27 patients with recurrent disease after radiotherapy and/or surgery, there were 9 (33%) partial responses. Among 6 patients having failed prior chemotherapy, there was 1 complete responder, still in remission at 26 months. Response frequency was highly dependent on performance status and stage of disease, with a response of 80% in the 0 performance status group and 83% for stages less than T₄N₃M₀. Among 18 patients with resectable disease, 51% remain disease-free at 12 months with an overall median survival of 16 months. Among the 33 patients with recurrent disease, the median duration of response and survival was 4 and 12 months for responders, respectively; nonresponders had a median survival of 5 months. The toxicity of this regimen was generally mild, with 21% of patients having no vomiting and 91% never having a serum creatinine over 2.0 mg/dL. There were 2 cases of pulmonary fibrosis. This chemotherapy regimen compares favorably with other published regimens for head and neck cancer with respect to activity and may be less toxic.