Toxicity of aggressive multimodality therapy including cisplatinum, bleomycin and methotrexate with radiation and/or surgery for advanced head and neck cancer
- Harvard Medical School, Boston
A combined modality regimen employing induction chemotherapy with cisplatinum, bleomycin and methotrexate followed by surgery and/or radiation therapy was initiated in patients with advanced squamous cell carcinoma of the head and neck. In the first 23 patients treated with this program there was a 90% response rate to induction chemotherapy (9% CR and 81% PR). Toxicity associated with radiotherapy, but not surgery, was increased with 11 of 23 patients (48%) who experienced some toxicity during or immediately after radiotherapy. Mucositis was worse than expected and severe delayed mucositis was seen in 2 patients, one of whom required hospitalization. Late complications, possibly related to therapy included one myocardial infarction and one episode of hypoglycemia, both of which were fatal. One other patient voluntarily failed to take prescribed oral leucovorin, dying of unrescued methotrexate toxicity during adjuvant therapy, a questionable suicide. Further follow-up analysis of failure will be necessary to determine if the value of a combined modality regimen in producing an increased cure rate and long term survival will out weigh increased toxicity.
- Research Organization:
- Harvard Medical School, Boston, MA
- OSTI ID:
- 6724415
- Journal Information:
- Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 8:5
- Country of Publication:
- United States
- Language:
- English
Similar Records
Multidrug chemotherapy (vincristine-bleomycin-methotrexate) followed by radiotherapy in inoperable carcinomas of the head and neck: preliminary report of a pilot study of the Radiation Therapy Oncology Group
Combination of cis-platinum and bleomycin prior to surgery and/or radiotherapy compared with radiotherapy alone for the treatment of advanced squamous cell carcinoma of the head and neck
Related Subjects
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
CARCINOMAS
CHEMOTHERAPY
RADIOTHERAPY
TOXICITY
MUCOUS MEMBRANES
DELAYED RADIATION EFFECTS
SIDE EFFECTS
HEAD
NECK
SURGERY
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
DISEASES
MEDICINE
MEMBRANES
NEOPLASMS
NUCLEAR MEDICINE
RADIATION EFFECTS
RADIOLOGY
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)
560306 - Chemicals Metabolism & Toxicology- Man- (-1987)