Treatment of advanced cancer of the head and neck with intensive preoperative irradiation and radical surgery

Surgical Treatment of Squamous Cell Carcinoma of the Oral Tongue: Factors Influencing Survival

“…However, there is wide and general agreement that cervical node metastases are best treated by surgery or combined treatment. [2][3][4] Experienced radiotherapists believe that with modern equipment and refined techniques one can eradicate early cancer of the tongue in a substantial proportion of cases with minimal stigmata and with preservation of functional integrity exceeding that following a surgical procedure. [5][6][7] Others take the view that both modalities are equally effective in early lesions (less than 3 cm) and the choice of one over the other depends on the facilities at hand and the experience and skill of the clinician.1.8 However, as larger and more advanced primary lesions are encountered and the incidence of metastases to the regional nodes increases, the chance of ultimate control diminishes in spite of more radical surgery or improved radiotherapeutic techniques.1.9 In the latter cases, some authors believe that a combination of preoperative radiotherapy followed by radical surgery offers the best chance for cure.…”

Role of Surgery in Head and Neck Cancer With Fixed Nodes

“…The following is a summary of the operative procedures performed: (1) composite resection en bloc with neck dissection, four patients; (2) (Figure). The other ten showed histologically positive nodes in all of the neck specimens, with high node counts in several patients.…”

Randomized study of control of the primary tumor and survival using preoperative radiation, radiation alone, or surgery alone in head and neck carcinomas

“…Many authors have reported seemingly improved local control, though not always with increased survival, when preoperative radiation was used [Constable et al, 1972;Donald, 1977;Goldman et at, 1972;Hendrickson et al, 1968: Levitt andKing, 1971 ;Krause and McCabe, 1973;Powers and Ogura, 1969;Roswit et at, 1972;Salmo et al, 1977;Sanfillipo et al, 1969;Wanget al, 19721. Equivalent dosages of 3000 rads/3 weeks or less (note that 2000 rads/l week is nearly equivalent to 3000 rads/3 weeks) may have less efficacy than higher dosages [Lawrence et al, 1974;Ogura and Biller, 1970;Powers and Ogura, 19691.…”

“…Equivalent dosages of 3000 rads/3 weeks or less (note that 2000 rads/l week is nearly equivalent to 3000 rads/3 weeks) may have less efficacy than higher dosages [Lawrence et al, 1974;Ogura and Biller, 1970;Powers and Ogura, 19691. On the other hand, preoperative dosages in excess of 5000 rads/5 weeks may have higher complication rates [Donald, 1977;Gall et al, 1977;Goldman et al, 1972;Lawrence et al, 1974;Levitt and Kmg, 1971 ;Salmo et al, 1977;Sanfillipo et al, 1969;Vandenbrouck et al, 19771. The short interval of two weeks between high dose preoperative radiation and surgery in the randomized series from the Gustave-Roussy Institute may have contributed to their high complication rate, however [Vandenbrouck et al, 19771.…”