Prognostic significance of tumor growth during radiation therapy

A retrospective review of 282 consecutive patients with squamous cell carcinoma of the head and neck that were seen in the Radiation Oncology Department from January 1, 1980, through December 31, 1983, was performed. From this population a subgroup of six patients was identified that experienced growth of tumor in the radiation field during treatment. All except one of these patients expired from progression of cancer within 16 months. At the time of writing, the one remaining patient has progressive cancer in spite of additional therapy. Growth of cancer in the radiation field during therapy is unusual. It appears to be associated with a very poor prognosis even with aggressive salvage therapy. This observation should be taken into consideration in the medical/surgical management of these patients.