A Multikine solution (Cel Sci Corporation) was injected peritumorally (patients 1-11) or perilymphatically (patient 12) for 10 days. The manufacturer lists the following components in the Multikine solution: IL-2, IL-1α, IL-1β, granulocyte-macrophage colony-stimulating factor, interferon α, tumor necrosis factor α, tumor necrosis factor β, IL-3, IL-4, IL-6, IL-8, IL-10, macrophage inflammatory protein 1α, and granulocyte colony-stimulating factor. For the peritumoral approach, the total quantity of 2 or 4 mL was divided into 4 equal parts and injected at 4 equidistant points along the periphery of the tumor to a depth of 5 mm. For the perilymphatic approach, the total quantity of 4 mL was divided and injected at 4 arbitrary points at the periphery of the mastoid tip adjacent to the jugulodigastric nodes. Ten patients (patients 1-10) received 800 U, and 2 (patients 11-12) received 1600 U, at a concentration of 400 U/mL. (According to protocol stipulation, the first 10 patients to participate in the study received a total dosage of 800 U, whereas the next 10 were designed to receive 1600 U in an attempt to evaluate the effect of dose on tumor regression.) The treatment protocol also included the following: intravenous cyclophosphamide in a single low dose of 50 mg/m2 to reduce suppressor T-lymphocyte activity; intraoral indomethacin, 75 mg, from day 1 to day 21, to decrease levels of prostaglandin, which mediates macrophage-induced immune suppression23; and oral zinc, 142 mg, from day 1 to day 21, to augment T-lymphocyte function.24 Patients were advised to undergo either surgery or radiation as definitive treatment at 21 days after completion of the study protocol.