Abstract
The recent developments in anti-cancer chemotherapy have led to a gradual increase in successful treatment of head and neck cancer.
Many anti-cancer chemotherapeutic methods have been used, but the direct effects of the various combination methods using CDDP appear particularly valuable at present.
For this reason, over the past 4 years and 3 months, we have treated cancer patients using Neo-adjuvant chemotherapy, with the main treatmental agent of CDDP in conjunction with PEP, MMC, MTX and others. 9 chemotherapeutic regimens were used. Divided into the PP method, the PPM method, and the P-others method. The most commonly used regimen-PP-3, consisted of the continuous infusion or arterial perfusion method of CDDP and PEP, with dosages varied with each trial. A total of 42 patients with a mean age of 58.5 years were treated. The main tumor affected regions, (accounting for 76.1% of all cases) were the maxillary sinus, buccal mucous membrane, mandibular gingiva and tongue.
Histologically, these tumors consisted of the following: 31 new cases and 6 recurrent cases of squamous cell carcinoma, one primary case and one recurrent case of adenoid cystic carcinoma, one case each of mucoepidermoid carcinoma, adeno carcinoma and one case undefined by histological diagnosis.
The overall response rate exhibited was 57.1%. Broken down, this includes 70.9% of new cases of squamous cell carcinoma, 16.6% of recurrent cases, and 20.1% of the non-squamous cell carcinoma. The rate of response fell gradually according to tumor growth.
A clear correlation was seen between histological differentiation and the effect of Neoadjuvant chemotherapy with well differentiated cases exhibiting a high rate of response in both new and recurrent cases.
However, differences in the response rate were observed between the continuous infusion method and the arterial perfusion method. Of four cases treated by arterial perfusion, two showed complete response (CR), and two partial response (PR), the two CR cases both being of low differentiation.
Various treatment methods were used in applying Neo-adjuvant chemotherapy to head and neck cancer. In terms of effect, and in consideration of side effects, we found the arterial perfusion method to be very useful.
