Combination of irradiation and surgery

Irradiation can eradicate the microscopic disease that radical surgical procedures cannot remove, but high doses of irradiation fail to control large volumes of cancer. The concept "either irradiation or surgery" for all clinical situations should be eliminated. If irradiation has no place as the sole treatment for a disease, for example soft-tissue sarcomas or parotid tumors, it does not mean that it has no place in the management of the disease. Conservatism in both disciplines is to be preferred. Not only are the chances for cure increased, but also the quality of life is improved. On theoretical grounds, preoperative irradiation is to be preferred, but the sequence of te modalities of treatment depends upon the structures involved, the extent of the surgical procedure, the dose of irradiation, and the volume irradiated. Examples and results of the combined treatment in various disease areas are given.