Radiation Therapy of Head and Neck Cancer

The contemporary management of patients with cancers of the head and neck is under careful scrutiny and major changes are being introduced in order to improve the potenti­ al not only for long-term control but also for less in the way of disfiguring and distres­ sing complications associated with the treatment programs. In 1988, the American Cancer Society estimates that there will be 42400 new cases of malignant tumors of the head and neck diagnosed with 12 850 deaths. In general, the prognosis for patients with malignant tumors of the head and neck re­ gion depends upon the site of origin, the local and regional extent of the tumor, the Kar­ nofsky status of the patient as well as the patient's general medical condition. The poten­ tial for cure for early stage tumors is extremely high particularly for those lesions involving the vocal cord, oral cavity, and the anterior two-thirds of the tongue. Major advances have been made in the management of head and neck cancer by the innovative utilization of surgery with radiation therapy. Small tumors can be cured by ei­ ther surgery or radiation therapy with equally good results. However, far advanced tu­ mors are more complicated and more difficult to cure requiring combined, integrated, multimodal programs of management. Therefore, the previously general poor prognosis for advanced tumors is becoming better with more aggressive treatment regimens.