Studies on chemotherapy of advanced or recurrent head and neck cancer for purposes of prolongation of life with improvement of quality of life

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1. Fundamental research; We tried to evaluate the effect of combination of carboplatin (CBDCA) and peplomycin (PEP) on experimental study defore applying the combination therapy clinically. Male BALB/c nude mice and three unde mouce-grown squamous cell carcinoma of head and neck origin were used in the present study. The results revealed statistically no different anti-tumor activity between the combination therapies on three nude mouse-grown human squamous cell carcinomas. If so, this combination may be more useful clinically in terms of lower nephrotoxicity resulting in no phdration durig the treatment.2. Clinical research: In our department, 109 patients with advanced or recurrent head and neck cancer received palliative chemotherapy for the purpose of prolonging life and improving quality of life throughout the past 11 years. Single or combined agents including CDDP, bleomycin analogs, methotrexate, vincristine etc were used. The 5-year survival ratge was 3.3% in this series. We also evaluated the quality of life of all patients receiviving chemotherapy. An improvement of quality of life was observed in 39 of them. The lives of the 30 patients, whose performance status improved after chemotherapy, were prolonged and they enjoyed their home lives while receiving treatment at the outpatient level. The use of chemotherapy at the outpatient level will be increasingly important in the future. From our longtime experiences on chemotherapy of the head and neck cancer, we recognized several combinations in which noncross-resistance was observed. They include UFT+BM therapy (bleomycin, mitomycin C), UFT-M therapy (UFT, mitomycin C) + CP therapy (CDDP, PEP), VMB therapy (vincristine, methotrexate, bleomycin) + CP therapy etc. At present, we recommend noncross-resistant sequential chemotherapy consisting ofm VMP therapy (vincristine, methotrexate,PEP) or VDMP therapy (vindesine, methotrexate, PEP) nad CDDP containing regimen like CP therapy or CDDP + 5-fluorouracil.