Abstract
Patients with advanced and/or recurrent head and neck cancers were enrolled for the present studies to investigate the effectiveness and the toxic effects of our sequential combination chemotherapy including cis-platinum. The patients entered for the present protocol were divided into two groups: 19 patients for Regimen I (cis-platinum, vincristine and peplomycin) and seven patients for Regimen II (cis-platinum, adriamycin, and cyclophosphamide). Two patients were excluded because of diiculity in the evaluation of tumor response. The overall response rate of the remaining 24 patients was 35%. Six patients received the treatment as neo-adjuvant chemotherapy, and two of them achieved partial remission.
Side effects were nausea and vomiting (54%), decreased creatinine clearance (27%), leukopenia (23%) and anemia (3l%). We were obliged to discontinue the protocol after completion of the first course in six of the seven patients with decreased creatinine clearance. Elevation of the serum iron level was seen three days after cis-platinum administration in all patients. Since this elevation of the serum iron level was also noted after VBM and COP, we assumed that the effect of anticancer drugs on the ferrokinetics in the bone marrow could account for it.
