Experience with preoperative irradiation in head and neck cancer

Experience with 47 patients with head and neck carcinoma operated after preoperative megavoltage irradiation of about 3 000 rads over 3 weeks is reported. The 3-year survival for the series was 25/47 (53%), for the cases of Stages I--II 13/19 (68%) and Stages III--IV 12/28 (43%). Neoplastic cells could not be detected in 18% of the cases at operative biopsy. The remaining neoplastic cells were considered to be degenerated and non-vital in 14%, but in 68% of the cases the histological examination revealed a viable neoplasm. Changes in the macroscopic appearance did not correlate very well with the histological findings. Disadvantages of the irradiation were so minimal that the authors consider the general application of preoperative radiation in the therapy of head and neck malignancies to be the treatment of choice.