Combination chemotherapy with vinblastine, bleomycin, and cis‐diamminedichloroplatinum (ii) in squamous cell carcinoma of the head and neck

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Abstract
Patients (45) with advanced squamous cell carcinoma of the head and neck, 23 of whom had received no prior therapy, were given the following combination: vinblastine, 4 mg/m2 i.v. on day 1; bleomycin, 15 mg/day i.m. on days 1-7; and cis-diamminedichloroplatinum (II), 60 mg/m2 with mannitol diuresis on day 8. The regimen was repeated at 3 wk intervals, for a maximum of 3 cycles. Among the 23 patients without prior surgery or radiation, there were 5 complete responses and 12 partial responses (74% response rate); among the 22 with prior therapy, there were 2 complete responses and 8 partial responses (45% response rate). Of 23 previously untreated patients, 19 were subsequently given radiation; 1 had surgery and 1 had surgery plus radiation. Twelve of these 19 patients are currently free of disease, with a median duration of 10 mo. from initial response. Four of the 22 previously treated patients received radiation and 2 received surgery; 4 of these 6 patients are without evidence of disease. Renal dysfunction with elevation of serum creatinine occurred in 5 patients, a leukocyte count of less than 3000/mm3 in 3, a platelet count of less than 100,000/mm3 in 2, skin changes in 11, hearing loss in 1, and peripheral neuropathy and pulmonary changes in 1 patient. This combination of agents had substantial activity in untreated patients and may be useful as initial therapy in advanced head and neck malignancies by diminishing the incidence of local recurrence and distant metastasis.