Post-operative radiotherapy in the management of advanced intra-oral cancers

Advanced tumours of the tongue and floor of the mouth have a poor prognosis when treated by surgery or radiotherapy alone. The results reported here suggest that combined surgery and radical post-operative radiotherapy greatly improve the outlook for such patients. When the oral cavity is irradiated, both parotids usually receive a radical dose resulting in xerostomia. In this study, shaped fields are used to spare the contralateral parotid, thus minimising the reduction in saliva production. Previously, radical surgery of oral tumours left the patient deformed. Plastic surgery techniques of reconstruction using radial free flaps give excellent cosmetic results. Radial free flaps have their own blood supply and tolerate a radical dose of radiotherapy.