Lester E P, Kinnealey A, Matz G J
Laryngoscope. 1979 Dec;89(12):1921-9. doi: 10.1288/00005537-197912000-00004.
Thirty-four patients with advanced squamous cell carcinoma of the head and neck have been treated with sequential combination chemotherapy consisting of Cytoxan, methotrexate, oncovin, bleomycin and adriamycin, followed by Leucovorin (COMBAL). All patients had undergone extensive prior radiation and/or surgery. All the patients had recurrent cancer. Toxicity included two deaths from drug induced pancytophenia and one from sepsis. Treatment was well tolerated and could be given in the outpatient clinic. No bleomycin pulmonary or adriamycin cardiac toxicity was seen. Results include 4 patients who achieved complete remission, objective improvement in measurable lesions in 6 others, stabilization of disease for 1 to 3 mo. in 5, and progression of disease in 13. Survival has ranged from 1 to 19+ months with a median of 10.7 mo. for patients that were evaluated. We conclude that COMBAL produces objective evidence of improvement in approximately 45% of patients with far advanced, previously treated squamous cell carcinoma of the head and neck.
34例晚期头颈部鳞状细胞癌患者接受了由环磷酰胺、甲氨蝶呤、长春新碱、博来霉素和阿霉素组成的序贯联合化疗，随后使用亚叶酸钙（COMBAL方案）。所有患者此前均接受过广泛的放疗和/或手术治疗。所有患者均为复发性癌症。毒性反应包括2例因药物性全血细胞减少死亡，1例因败血症死亡。该治疗耐受性良好，可在门诊进行。未观察到博来霉素肺部毒性或阿霉素心脏毒性。结果包括4例完全缓解患者，另外6例可测量病灶客观改善，5例疾病稳定1至3个月，13例疾病进展。评估患者的生存期为1至19个多月，中位生存期为10.7个月。我们得出结论，COMBAL方案使约45%的晚期、先前接受过治疗的头颈部鳞状细胞癌患者出现客观改善迹象。
