Preoperative Irradiation in Head and Neck Cancer Surgery

Abstract

RADICAL RADIATION therapy and radical surgical therapy have both failed to cure a large proportion of patients with moderately advanced carcinoma of the head and neck.^1-3 These failures occur for a number of reasons including distant dissemination of disease, local recurrence of the tumor in the operative site, or recurrence of the tumor in the regional lymph node distribution. A proportion of patients with far-advanced head and neck malignancies have evident distant metastases that preclude radical surgical or radiotherapeutic attack of the primary problem. In addition to those patients with clinically evident metastases, a number probably have clinically unrecognized dissemination of the disease which will appear only some period after therapy is performed and which might be incorrectly assessed as failure of the therapeutic mechanism whereas really the failure had existed before therapy was instituted.^4,5 However, in patients with malignant tumors of the upper respiratory and upper digestive