O'Connor A D, Clifford P, Smith D J, Edwards W, Hollis B A, Dalley V M
Clin Otolaryngol Allied Sci. 1977 Nov;2(4):347-57. doi: 10.1111/j.1365-2273.1977.tb01378.x.
Since April 1974, 60 patients with squamous cell carcinoma of the head and neck region, of poor prognosis and generally in advanced stages, were treated with the combination of a cytotoxic regimen--VBM (Vincristine, Bleomycin and Methotrexate) and radical radiotherapy. The essential feature of the combination is the administration of pulses of VBM synchronous with a course of fractionated external radiotherapy in order to achieve potentiation of radiotherapy. On average 4-5 pulses of VBM were given during treatment, combined with radiotherapy on a Cobalt unit. The selection, preparation and management of the patients are described. Intense mucositis and intercurrent infection provide the main problems during treatment and close management is essential. Late complications have not been a serious problem. The crude actuarial survival rate at 24 months is 61%. The probability of survival without any recurrence to 24 months following initial treatment is 46%. Local control was achieved by the initial treatment in 43 patients. These results suggest that potentiation of radiotherapy and an increased therapeutic ratio has been obtained by the addition of VBM to radiotherapy and there is a possibility that the occurrence of distant metastases has been reduced or postponed.
自1974年4月以来，60例头颈部鳞状细胞癌患者，预后较差且通常处于晚期，接受了细胞毒性方案——VBM（长春新碱、博来霉素和甲氨蝶呤）与根治性放疗联合治疗。该联合治疗的主要特点是在分次体外放疗疗程中同步给予VBM脉冲，以实现放疗增敏。治疗期间平均给予4 - 5次VBM脉冲，并结合钴治疗机进行放疗。描述了患者的选择、准备和管理情况。严重的黏膜炎和并发感染是治疗期间的主要问题，密切管理至关重要。晚期并发症并非严重问题。24个月时的粗精算生存率为61%。初始治疗后无任何复发至24个月的生存概率为46%。43例患者通过初始治疗实现了局部控制。这些结果表明，放疗联合VBM可实现放疗增敏并提高治疗增益比，且有可能减少或推迟远处转移的发生。
