Summary
A phase III 2x2 factorial trial of cisplatinum and bleomycin in 116 patients with recurrent or advanced squamous cell carcinoma of the head and neck is reported.
Thirty percent of patients proved to be unfit for chemotherapy, and of those treated progression of tumour was the commonest “response”. However, 25% of patients achieved a partial or complete response, with no significant difference in response rates between the treated arms.
The median number of courses received was 1 (range 0–6) and the commonest causes for discontinuation of treatment were renal toxicity and death.
Bleomycin reduced survival, but not significantly so, whereas cisplatinum prolonged median survival significantly by 10 weeks.
Significant predictors of survival, in addition to treatment by cisplatinum, were age, performance status, N status, number of courses and response of the tumor.
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References
Armitage P (1971) Statistical methods in medical research. Blackwell, Oxford
Cachin Y, Jortay A, Sanchos H, Eschwege, F, Madelain M, Desaulty A, Gerhard P (1977) Preliminary results of a randomized E.O.R.T.C. study comparing radiotherapy and concomitant bleomycin to radiotherapy alone in epidermoid carcinomas of the oropharynx. Eur J Cancer 13: 1389–1395
Jacobs C, Meyers F, Hendrickson C, Kohler M, Carter S (1983) A randomised phase III study of cisplatin with or without methotrexate for recurrent squamous cell carcinoma of the head and neck. Am Cancer 52: 1563–1569
Karnofsky DA, Buchenall JH (1949) The clinical evaluation of chemotherapeutic agents. Columbia university press, New York, pp 191–205
Kish JA, Weaver A, Jacobs J, Cummings G, Al-Sarraf M (1984) Cisplatin and 5-fluorouracil infusion in patients with recurrent and disseminated epidermoid Cancer of the head and neck. Cancer 53: 1819–1824
Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47: 207–214
Peto R (1978) Clinical trial methodology. Biomedicine 28: 24–36
Peto R, Pike MA, Armitage P, Breslow NF, Cox DR, Howard SV, Mantel N, McPherson K, Peto J, Smith PG (1977) Design and analysis of randomised clinical trials requiring prolonged observation of each patient. Br J Cancer 35: 1–39
Stell PM, Morton RP (1982) Average survival times after treatment of cancer. Clin Oncol 8: 293–303
Stell PM, Dalby JE, Strickland P, Fraser JG, Bradley PJ, Flood LM (1983a) Sequential chemotherapy and radiotherapy in advanced head neck cancer. Clin Radio 43: 463–467
Stell PM, Morton RP, Campbell IT, Wilson JA (1983b) Survival after palliative cytotoxic chemotherapy for head and neck cancer. Lancet II: 1205
Stolwijk C, Van den Broek P, Wagener DJT, Levendaag PA, Kazim I (1983) Randomized adjuvant chemotherapy trial in advanced head and neck cancer. Clin Otol 8: 285
Tannock I, Sutherland D, Osoba D (1982) Failure of shortcourse multiple-drug chemotherapy to benefit patients with recurrent or metastatic head and neck cancer. Cancer 49: 1358–1361
Taylor SG (1979) Head and neck cancer. In: Pinedo HM (ed) Cancer chemotherapy. EORTC cancer chemotherapy annual, I. Excerpta Medica Amsterdam
Taylor SG (1981) Head and neck cancer. In: Pinedo HM (ed) Cancer chemotherapy. The EORTC cancer chemotherapy annual, 3. Excerpta Medica, Amsterdam
Taylor SG (1982) Head and neck cancer. In: Pinedo HM (ed) Cancer chemotherapy. The EORTC cancer chemotherapy annual 4. Excerpta Medica, Amsterdam
UICC: TNM classification of malignant tumours, 3rd edn. Geneva 1978
Warr D, McKinney S, Tannock I (1984) Influence of measurement error on assessment of response to anticancer chemotherapy: proposal for new criteria of tumor response. J Clin Oncol 2: 1040–1046
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The work described in this paper was supported by the North West Cancer Research Fund
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Morton, R.P., Rugman, F., Dorman, E.B. et al. Cisplatinum and Bleomycin for advanced or recurrent squamous cell carcinoma of the head and neck: a randomised factorial phase III controlled trial. Cancer Chemother. Pharmacol. 15, 283–289 (1985). https://doi.org/10.1007/BF00263902
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DOI: https://doi.org/10.1007/BF00263902