Surgery and postoperative external irradiation for head and neck cancer recurrent after surgery alone

The radiotherapeutic salvage of recurrent head and neck carcinoma after definitive surgery was retrospectively studied in 20 patients treated between 1972 and 1985. These individuals had external beam megavoltage irradiation for subclinical (n = 7) or gross (n = 13) disease. The conventionally applied total dose ranged from 4,600 cGy to 7,000 cGy (mean 6,000 cGy). Overall 2- and 5-year crude survival rates were 25% and 5%, respectively. Regional recurrence was more frequent than local disease. The latter was associated with a better prognosis. As expected, radiotherapy was relatively more effective for minimal (than for bulky) disease. In conclusion, the prognosis for recurrent head and neck carcinoma remains poor despite local therapy.