The consequences of immobilization error are explored through a model involving the tumor dose-response characteristics. The quantitative effect of such an error depends upon the field size, the shape of the dose-response function, and the position of the nominal dose being delivered on the dose-response function. Squamous-cell carcinoma of the supraglottis and Hodgkin's disease are discussed and values are calculated for the change in tumor control probability which might accompany immobilization error.
Eighty-one patients with preinvasive carcinoma of the vocal cord, seen over a thirteen year period, were reviewed histologically and analyzed for response to treatment. Sixty-seven cases were clinically T1 and fourteen cases T2 (by virtue of extension of disease beyond the vocal cord). All patients had mobile cords. Histological criteria for in situ carcinoma and the spectrum of microscopic patterns are presented. Sixty-nine patients were treated by external beam radiotherapy--the remainder by a variety of surgical procedures. Five and ten year actuarial, recurrence-free rates 83% and 75%, respectively for the group treated by irradiation. No difference in local control was observed when analyzed for: 1) dose response, 2) initial extent of disease, 3) treatment plan, or 4) histologic diagnosis. Analysis of failures reveals that 15/17 patients with local failure were salvaged, eleven of these patients requiring laryngectomy. Time to appearance of recurrence ranged from seven to one hundred and seven months.
A simple, disposable afterloading applicator for intracavitary irradiation of carcinoma of the nasopharynx has been found useful as a supplementary radiation boost to the primary site. Hopefully, local tumor control can be enhanced by employing this technique.
Transitional cell carcinoma of the nasal passages and sinuses is an uncommon tumor of the head and neck, for which the efficacy of chemotherapy has not been previously reported. A dramatic and complete tumor response to chemotherapy with cis-platinum, methotrexate, and bleomycin is described in a patient with advanced proptosis due to extensive local recurrence of transitional cell carcinoma. Relevant literature on this rare histologic type of head and neck cancer has been reviewed.
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