COMBINED RADIOTHERAPY AND BLEOMYCIN IN PATIENTS WITH INOPERABLE HEAD AND NECK-CANCER WITH UNFAVORABLE PROGNOSTIC FACTORS AND SEVERE SYMPTOMS

The aim of this study was to assess the feasibility of concurrent spli t course radiotherapy and low-dose bleomycin in the treatment of unres ectable head and neck cancer with unfavourable prognostic factors and severe syptoms. The clinical outcome of the treatment was assessed in terms of local disease control, symptom relief and toxicity. Between 1 990 and 1996, 58 patients with squamous cell carcinoma of the head and neck, stage III or IV, were treated by radiotherapy (50 Gy/20 fractio ns) and simultaneous bleomycin (60 mg/6 fractions). Local control of d isease, overall response, symptom relief and acute toxicity were evalu ated. The rate of disease local control was 69% with a median response duration of 7 months (range 2-43 +). The symptom relief rate was 81%. Mucositis was the prominent toxicity: G3 mucositis was reported in 27 patients. In conclusion, the treatment was feasible, a good palliatio n of symptoms and a good rate of local response were obtained. Moreove r, toxicity was tolerable and the rate of hospitalisation was low. (C) 1998 Elsevier Science Ltd. All rights reserved.