XXVI Pre-Operative Radiation in Head and Neck Cancer

Abstract

A program of combined pre-operative irradiation therapy has been presented. Cases included in this study were those which, based upon previous experience, were operable but judged to have a prognosis of less than 50% 2 yr. survival. The methodology and protocol of irradiation therapy is presented. A tabulation of all patients in the entire study is included and discussion of survival is centered about those patients in whom surgery was performed at least 2 yr. prior to this publication. The histological changes that occur with irradiation therapy are noted. Attention is drawn to the fact that random histological samplings of the en bloc dissections serially sectioned demonstrated that in no case was there complete eradication of the tumor either in the primary site or in the metastatic lymph node following irradiation therapy. It is also noted, however, that in certain select instances in which a tumor regressive response occurred, a conservation type of procedure was performed. Postoperative complications, namely, those of pharngocutaneous fistulae and carotid artery hemorrhage, are mentioned.