CHEMOTHERAPY in head and neck cancer had its clinical beginning in December 1942. Gilman and Philips, 1 Hunt and Philips, 2 and Goodman et al 3 while studying top secret nitrogen mustard and its biological behavior at Yale University discovered its cytotoxic role when absorbed. Following extensive studies on animal tumors it was first used in man under the guidance of Gustav E. Lindskog. His first case was a radio-resistant terminal lymphosarcoma with massive involvement of the face, neck, mediastinum, and axilla. The tumor response was dramatic, only to be followed by severe bone marrow depression. As the bone marrow function returned, so did the tumor. This is indeed a familiar story to all of us who are working in this field 23 years later. The alkylating agents were the first drugs to be used in an effort to destroy tumors by interfering with cell reproduction, but it was not