The favorable results obtained by other authors with polichemotherapy encouraged us to employ therapeutic scheme using a combination of 4 drugs. Treatment envolved the administration of 300 mg/m2 cyclophosphamide, 350 mg/m2 5-fluorouracil, 10 mg/m2 methotrexate i.v. on alternate days 6–8 times, and 15 mg bleomycin on alternate days until a total dose of 150–200 mg is reached. Thirty-five out of 37 patients treated with this protocol (30 previously treated and 5 not) qualified for analysis; the site of the neoplasm, mostly squamous cell carcinoma, was different; for the most part it was in the larynx (18/35) and the oral cavity (10/35). Complete remission was achieved in 9/35 patients (25.7%), varying from 5 to 33 months (median 22); partial remission was achieved in 15/35 cases (42.8%), varying from 1 to 14 months (median 3); and there was no success in 11/35 cases (31.5%). Overall, a total remission > 50 % was observed in 24/35 patients (68.5 %). The most serious side effects both ascribed to BLM were observed in the central nervous system (increasing drowsiness and coma) and the lung. This study has shown that in the ultra head and neck malignancies medical treatment can achieve satisfactory results.
Intrathecal rituximab for EBV-associated post-transplant lymphoproliferative disorder with central nervous system involvement unresponsive to intravenous rituximab-based treatments: a prospective study
