Preoperative irradiation for head and neck cancer: A prospective study

A prospective clinical trial of preoperative irradiation for Stage II, III, and IV squamous carcinoma of the head and neck was initiated at the Medical College of Virginia in January, 1969. In patients receiving preoperative therapy, treatment was calculated to give a midline total dose of 1,400 rads in two equal fractions delivered 24 and 48 hours prior to the surgical procedure for oral cavity, oropharyngeal, or pharyngeal cancer. The surgical procedure in all instances consisted of wide resection of the primary lesion in continuity with unilateral or bilateral neck dissection. By December 31, 1972 there were 143 patients entered into this study with followup periods ranging from 6 to 54 months. The morbidity, mortality, and survival characteristics of the preoperative irradiation and “surgery only” groups are essentially the same. No significant difference in local recurrence rate has been observed between the two groups. Although the different anatomical sites cannot be individually examined at this time, it is considered that no major change in clinical course will result from this type and dosage of preoperative irradiation to Stages II, III, and IV squamous carcinoma of the oral cavity, oropharynx, and pharynx.