Studies on development of a new multidisciplinary treatment incorporating neo-adjuvant chemotherapy for head and neck cancer

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1. Fundamental research: (1)Combination chemotherapy of 4'-0-tetrahydropyranyladriamycin(THP),cisplatin(CDDP) and peplomycin(PEP) was studied using Ehrlich ascites carcinoma in ICR mice. As a result, it was concluded that sequential use of THP,CDDP and PEP was most effective. The mechanism of synergism was also studied using flow cytometry. (2)In order to test the advantage or usefulness of initial chemotherapy followed by radiotherapy(pre-radiation chemotherapy), the experimental study on combination of chemotherapy and radiotherapy was designed by using ICR mice and Ehrlich solid carcinoma. The results obtained were as follows: Synergistic effect of chemotherapy and radiotherapy was observed when chemotherapy was used prior to radiotherapy on Ehrlich solid carcinoma. On the other hand, even their additional effect was not recognized when radiotherapy preceded to chemotherapy on Ehrlich solid carcinoma. So the experimental results made it clear that pre-radiation chemotherapy is beneficial to to the treatment of the head and neck cancer.2. Clinical research: (1)We have started a new multidisciplinary treatment incorporating neo-adjuvant chemotherapy with CDDP and PEP since May 1981. The results of this treatment were evaluated. Five-year survival of all patients was 45%, which was relatively good considering that 80% of patients in this series were in stage III and IV. Five-year survival was significantly high in patients achieving CR with CDDP-PEP therapy (2)Clinical trial of combination chemotherapy with THP or adriamycin, CDDP and PEP was conducted for advanced head and neck cancer. Out of 25 patients, CR was achieved in 4 and PR in 11 with a response rate of 60%. So that, this combination was incorporated into neo-adjuvant chemotherapy.