Chemotherapy of head and neck cancer: Combination treatment with cyclophosphamide,adriamycin, methotrexate,and bleomycin

A combination of cyclophosphamide, adriamycin, methotrexate, and bleomycin (CAMB) was explored in patients with advanced, nonresectable epidermoid carcinoma from primary sites in the head and neck, recurrent or persistent after radiation or surgery. Objective regression (greater than 50%) of measurable tumor was present in 35% of the patients. The median duration of response was 2.5 months. Median survival of responders was slightly less than the nonresponders, but the difference was not significant. Drug-related morbidity was substantial; leukopenia, mucositis, and weight loss were the most frequent major side effects. Three deaths were attributable to the regimen. The results seem comparable to those one might expect from methotrexate alone.