Induction chemotherapy with cisplatin, etoposide, and mitomycin-C (PEM) regimen in advanced cases with cancer of pharynx and oral cavity.

With the aim of improving survival rate in advanced head and neck cancer, we scheduled 26 patients to receive PEM regimen. This regimen consisted of cisplatin (CDDP)(P), etoposide (VP-16)(E), and mitomycin-C (MMC)(M) (CDDP 60 mg/ m2/2 hr infusion on day 1; VP-16 40 mg/m2/1 hr infusion on days 1-3; MMC 7 mg/m2 iv bolus on day 1). Of 25 patients evaluable for response, 8 complete response (CR), 14 partial response (PR) were achieved, with an overall response rate (RR) of 88%. Myelosuppression was major side effect and thrombocytopenia (23% greater than WHO grade) was dose limiting toxicity. Other adverse reactions including mucositis were all mild and transient. Since limited mucosal toxicity, full course of following treatment including radiotherapy and/or surgery could be done satisfactorily. We concluded that this regimen produced beneficial effect as the adjuvant setting in patients with cancer in pharynx and oral cavity because of limited mucosal toxicity.