30 patients with advanced squamous cell carcinoma of the head and neck received initial chemotherapy with Cisplatin (100 mg/m2 i.v. day 1) and 5-Fluorouracil (1000 mg/m2 as 24-hour-infusion day 2-6). 1 patient reached complete remission, 16 patients presented a partial remission, 11 patients showed little response and 2 patients had progressive disease. Following chemotherapy, 29 patients were referred to surgery and/or irradiation. 16 patients received radical surgery. The surgical specimen of 5 patients had no histological evidence of cancer. Objective and subjective side effects of chemotherapy were serious and some patients refused further treatment or were rejected. The results were compared with the data from the literature. The considerably better results from Decker and Weaver et al. were partially explained by an overestimation of remission quality by clinical evaluation and by more therapy courses. At this time, there is no evidence of any benefit from chemotherapy, because there is no data on relapse free survival and over all survival. The position of chemotherapy in the multimodality treatment programme of head and neck cancer still needs to be discussed further.
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