A low dose combination chemotherapy with VCR, BLM and MTX (V-B-M) in a theoretically double synchronizing sequence was administered for palliative purpose to 84 patients with advanced squamous cell carcinoma of the head and neck. The treatment started with a weekly 3 days regimen (VCR 1 mg i.v., BLM 15 mg i.m. after 6 and 24 hr, MTX 20 mg/m2 p.o. after 48 hr for 4 weeks). BLM was then reduced according to two different regimens in order to protract the treatment avoiding cumulative toxicity of the drug. In 60 assessable patients, a good response was observed in 46 patients (76%), with 62% of regressions greater than 50% and 32% of complete responses; regressions greater than 50% were more frequent in patients not previously treated (88 v 51%). The duration of response was correlated with the degree of the regression: in the responders its median duration was 4.1 months. V-B-M was effective in reducing or eliminating pain in the great majority of the cases, and this result was often protracted after interruption of the chemotherapeutic treatment. No important toxicity was observed and no patient required hospitalization or specific treatment to control side effects.
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