Combined radiotherapy and CMF-B cytotoxic regimen in stage III-IV head and neck squamous cell carcinoma.

Twenty patients with stage III-IV squamous cell carcinoma of the head and neck were treated with the combination of a multidrug cytotoxic regimen CMF-B (cyclophosphamide, methotrexate, 5-fluorouracil, bleomycin) and radical radiotherapy. All the patients were evaluable: 7 (35%) achieved clinical complete response (CR), 10 (50%) partial response (PR) and 3 (15%) stable disease (SD). The median survival of the whole group is 14 months (range 3-26+); 21+ months for complete responders (range 4+-22+). Hematologic and gastrointestinal toxicity was moderate, 9 patients (45%) developed mucositis but only one needed total parenteral nutrition. It is concluded that the combination of CMF-B regimen and radiotherapy is effective and well tolerated in these patients and needs to be evaluated in further controlled studies.