Primary and metastatic adenocarcinoma and adenoid cystic carcinoma in the head and neck regions were treated by CAP therapy, a multiple combination chemotherapy consisting of cyclophosphamide (C), THP or adriamycin (A), and cisplatinum (P). This therapy was given once to 10 patients with primary adnocarcinoma, 5 with adenoid cystic carcinoma, and 2 with metastatic adenocarcinoma from the stomach. Following results were obtained: Complete response was detected in 6 patients and partial response was detected in 3 patients of adenocarcinoma. Efficacy rate was 75%. No response was observed in patients of adenoid cystic carcinoma. The average efficacy rate for the entire series was 53% (9/17), and the duration of efficacy ranged from 28 to 278 days (mean, 96.5 days).

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Effects of cis-platinum-peplomycin induction chemotherapy were evaluated in 28 head and neck carcinoma patients at Kurume University Hospital. The results were as follows: 1. The clinical effect was CR in 5, PR in 15 and NC in 8 cases. 2. Histologically, 2 cases were classified as Grade III, 3 cases as Grade II b and 14 cases as Grade II a change according to Ohboshi-Shimozato classification. 3. Conservation surgeries following cis-platinum-peplomycin induction chemotherapy were successful only in carcinomas which are highly radio-sensitive. The conservation surgery was followed by radiation therapy. 4. In some of those advanced carcinomas which were thought to be incurable, cis-platinum peplomycin induction chemotherapy proved to be effective to the extent that curative treatments become possible.

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As a preliminary study for neo-adjuvant chemotherapy in tongue cancer, pre-surgical treatment was analized in 156 tongue cancer patients treated at Gunma Cancer Center from 1973 to 1985. Among the 156 patients, pre-surgical treatment was performed in 114 patients (114/156, 71.3%). 104 of them were presurgically irradiated and pre-surgical chemotherapy was performed in only 10 patients. In 11 patients of pre-surgical irradiation, the dose was less than 10 Gy, 20 Gy to 40 Gy in 44 patient, and more than 40 Gy in 49 patients. In patients of pre-surgical chemotherapy, combined chemotherapy was performed in only two cases and result of these cases showed CR. CDDP, MTX and Peplomycin were used for this combined chemotherapy. Comparing pre-surgical irradiation and pre-surgical chemotherapy, it is clear that both have advantages and disadvantages. In general, the advantage of pre-surgical irradiation is that the treatment time is shorter than pre-surgical chemotherapy and side effects were milder than pre-surgical chemotherapy. Advantage of pre-surgical chemotherapy, on the other hand, is its usefulness in the prevention of distant metastasis. It is more effective than pre-surgical irradiation because the patient is treated with full doses of chemotherapeutic agents in certain cases.

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