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Abstract
The therapeutic effects of neo-adjuvant chemotherapy administered by two-route infusion
of cisplatin and its antidote, sodium thiosulfate, and intravenous infusion of vinblastine
and peplomycin were studied in 22 patients with previously untreated squamous cell
carcinoma of the oral cavity or maxillary sinus. The overall response rate to chemotherapy
was 90.9%, with a complete response in 12 patients (54.5%), a partial response in
8 patients (36.4%), and no change in 12 patients (9.1%). Histologic assessment showed
a grade V response in 7 patients (31.8%), grade IV in 3 patients (13.6%), grade III
in 5 patients (22.7%), grade II in 4 patients (18.2%), and grade I in 3 patients (13.6%).
The cumulative 5-year survival rate, including 3 patients who died of another disease,
was 72.2%. Leukocytopenia, an important side effect apparently induced by vinblastine,
was seen, but no life-threatening complications occurred. Renal toxicity by cisplatin
was minimal because of the use of sodium thiosulfate and fosfomycin. These data indicate
that this mode of chemotherapy may be more effective for treating head and neck cancer
than ordinary chemotherapy, from clinical and histologic stand-points. The high complete-response
rate is especially noteworthy. No serious side effects or reductions in treatment
period occurred. The results are preliminary and additional studies using a larger
patient population are needed.
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© 1995 Published by Elsevier Inc.
