Treatment results for simultaneous primary squamous cell carcinomas of the head and neck

Forty patients with simultaneous multiple primaries of the head and neck were treated with curative intent between June 1964 and April 1983. The primary sites were treated with radiation therapy alone or in combination with surgery. Surgery was used to salvage local failures of radiation treatment. Neck disease was treated with radiation therapy alone or with neck dissection added after completion of radiation therapy to the primary lesions. Minimum follow-up was 2 years with a range of 2 to 20 years. For the 32 patients whose primary tumors were treated with radiation alone, the 2-year local control rates for the 53 individual tumors evaluated were as follows: T1, 18/21; T2, 16/23; and T3-T4, 1/9. In the T3-T4 group, there was only one successful surgical salvage. Local control rates for disease at all primary sites in each patient according to highest T-stage were as follows: T1, 4/5; T2, 9/15; and T3-T4, 1/9. Eight patients whose primary tumors were treated with radiation and surgery are discussed. The absolute disease-free survival rate at 2 years for 40 patients was 42%. Complications of treatment are described.