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[Induction chemotherapy with cis-platinum in head and neck tumors. First clinical and histopathologic findings (author's transl)].

Twenty-one patients with advanced previously untreated squamous cell carcinoma of the oral cavity, oro- and hypopharynx and supraglottic region were treated with combined cis-platinum-methotrexate-bleomycin chemotherapy. Methotrexate (20 mg/m2) was given on day 1, after prehydration cis-diaminodichloroplatinum (60 mg/m2) was given with mannitol diuresis on day 2. From day 3 until day 8 15 mg bleomycin was given daily in a 6-h infusion. Three courses were given every 3 weeks. After clinical evaluation for tumor response all patients were operated and underwent postoperative radiotherapy. After induction chemotherapy eight patients (39%) had a complete, five (24%) a partial (shrinkage of measurable disease more than 50%), and seven (33%) a minor response (more than 25% but less than 50% tumor shrinkage). The neoplasms of the oral cavity and the pharynx responded better than the laryngeal primaries. Exophytic tumors responded better to chemotherapy than the endophytic tumors. Histopathologic examination in serial sections demonstrates in all cases--even after clinically complete response--some small rests of tumor in local fibrotic tissue often underneath a regrown mucosal epithelium.