Multidrug chemotherapy using bleomycin, methotrexate, and cisplatin alone or combined with radiotherapy in advanced head and neck cancer

Twenty-two patients with advanced cancer of the head and neck were treated with a combination of bleomycin, methotrexate, and cisplatin. In ten previously untreated patients, a complete response (CR) rate of 20%, a partial response rate of 50%, and a no change rate of 30% were observed. With the addition of radiotherapy, the local CR rate in this group of patients increased to 60%. In 12 patients with recurrent disease after surgery and/or radiotherapy, the CR rate was 25%, the partial response rate was 16.7%, and the no change rate was 58.3%. Toxic effects were acceptable, with no fatalities. These short-term results encourage accrual of more patients in the study and further follow-up to determine whether the cure rate can be increased by using cisplatin and radiotherapy in patients with advanced previously untreated head and neck cancer. More energetic treatment should be investigated in patients having disease recurrence after radiotherapy.