An effective combined therapy for advanced squamous cell carcinoma of the oral cavity: preoperative BVMM (bleomycin, vincristine, mitolactol plus methotrexate and leucovorin) chemotherapy followed by surgery.

Effects of preoperative chemotherapy with three courses of a combination of bleomycin, vincristine, mitolactol, prednisolone and methotrexate, with a leucovorin rescue, followed by surgery, were studied in 43 patients with advanced squamous cell carcinoma of the oral region. Prior to chemotherapy 32 patients (74%) had advanced T3 or T4 carcinomas whilst 11 patients had T2 lesions. All patients responded clinically to preoperative chemotherapy: 20 patients (46%) achieved clinically complete remission and 23 patients (54%) were judged as partial responders. Sideeffects of this combination chemotherapy were minimal and reversible. Between 15 and 22 days after the last course of chemotherapy the patients underwent surgery, after which 100% were judged to be disease-free. Wound healing complications did not occur. With a median follow-up of 23 months (range 8-45 months), 81% of patients are alive and 79% remain disease free. This combined therapy appears both safe and effective for advanced squamous cell carcinomas of the oral cavity.