Failure of short-course multiple drug chemotherapy to benefit patients with recurrent or metastatic head and neck cancer.

Fifty-seven patients with advanced cancer (52 with squamous cell carcinoma of the head and neck) were treated with short-course, multiple drug chemotherapy using schedules that were similar to those proposed by Price et al. Chemotherapy consisted of vincristine, methotrexate and folinic acid rescue, bleomycin, and FU, with or without Adriamycin and hydroxyurea. Most patients had received radiation therapy. There were only six objective responses (one CR, five PR) and except for one patient who is alive without disease following subsequent radiation the remissions were of short duration. Most patients tolerated treatment well but there was one toxic death, two sudden deaths of unknown cause, and renal impairment, mucositis, myelosuppression, or bleomycin skin toxicity in 14 others. Our results differ from those of Price et al. and do not support a role for this type of chemotherapy in the treatment of recurrent or metastatic head and neck cancer.