Journal of Chemotherapy Vol. 9 - n. 1 (72-76) - 1997
© E.I.F.T. srl - Firenze ISSN 1120-009X
INTRODUCTION
Of the solid tumors, squamous cell head
and neck cancer (SCCHN) is unusually sensi-
tive to chemotherapy. Even in patients with
recurrent or metastatic disease, a significant
response rate has been noted with a large num-
ber of single agents. Therefore chemotherapy is
considered standard practice in the treatment
of these patients. However, only a few of these
patients are cured. The best response rates vary
between 25% and 40%, with a median
Bleomycin, Epirubicin, Carboplatin (BECA) in the
Treatment of Recurrent and/or Metastatic Squamous
Cell Carcinoma of the Head and Neck
V. ADAMO - R. MAISANO
1
- S. PERGOLIZZI
1
- G. ALTAVILLA - N. CARISTI
G. CHIOFALO
1
- A. SCIMONE
1
- N. SETTINERI
1
Institute of Oncology and Research on Cancer of the University of Messina,
1
National Institute for Research on Cancer, Messina Section, Italy.
Correspondence: Dr. Vincenzo Adamo, Istituto di Oncologia, Università di Messina, C/da Papardo
Sperone, 98158 Messina, Italy. Fax: +39.90.392426.
Summary
The aim of this study was to evaluate three active agents, bleomycin (BLM), epirubicin
and carboplatin in a new combination (BECA) in terms of feasibility, activity and toxicity in
patients with recurrent and metastatic squamous cell carcinoma of the head and neck. From
April 1992 to February 1993 15 pts (12M/3F), median age 53 years, all pretreated (6
surgery+radiotherapy; 3 radiotherapy+chemotherapy; 6 radiotherapy), were treated with BLM
15 mg/m
2
days 1-14; epirubicin 30 mg/m
2
days 1-14 and carboplatin 300 mg/m
2
day 1 every
28 days. In the 14 evaluable pts we observed 1 complete response, CR (7.1%), 4 partial
responses, PR (28.6%), 5 stable disease, SD and 4 disease progression, PD with an overall
response of 35.7%. The treatment was globally well tolerated, 1 pt with grade 3 leukopenia
and 1 pt with grade 3 thrombocytopenia, 1 pt with grade 3 emesis and 1 pt with grade 3
mucositis. At the last follow-up the duration of CR was 34 months, the duration of PRs were
respectively 22-10-10-7 months, but the SD ranged from 4 to 6 months. The overall median
survival was 8 months (3-36), 14 for responders and 4 for non-responders. This final report
seems to confirm the activity and efficacy of the BECA regimen, suitable for outpatient
administration with an overall response equal to other more aggressive combinations.
Key words: Head and neck, squamous cell carcinoma, metastatic, bleomycin, epirubicin,
carboplatin.
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