The effects of combined treatment with radiation and bleomycin on the primary oral carcinoma

Abstract

Eighty-two previously untreated patients with squamous cell carcinoma arising from the oral mucosa were treated by concurrent combined treatment with 22.5 Gy of radiation and 110mg of bleomycin or 55mg of peplomycin at our department from 1976 to 1985. Therapeutic effects were examined clinically and histologically, and the role as a preoperative treatment was discussed.Moreover, a statistical analysis was performed to determine the factors related to the histological effects.
1. The ratio of complete response was 42.7% and the ratio of partial response was 89.0%.
2. 59 patients had subsequent treatment with surgery.Step sections were prepared from surgically resected specimens and examined microscopically.
1) According to Shimosato's classification of histological effects, 19 belonged to Grade IV, 15 to II b, 13 to II a and 12 to I/0.
2) In 7 of 15 Grade II b patients, residual survival cancer cells were not observed at the margin of the area previously occupied by tumor at the beginning of treatment.Accordingly, 44.1% (7with II b and 19 with III/IV) of 59 patients may be controlled by the more conservative surgery.
3. 18 patients with CR received additional combined therapy alone without any further treatment.Local control rate of these patients was 66.7%.Therefore, 31 patients (these 12 patients and 19 of Grade III/ IV) could be controlled by this therapy alone.
4. The histological effects significantly depended on the following factors of tumors;size, growth pattern, and degree of histologic differentiation.82.2% of 73 patients could be classified into good effective group or poor group accurately by the quantification theory Type II of Hayashi.It is considered that this method is useful for predicting the effects of this combined treatment.