Combined therapy in advanced squamous cell carcinoma of the head and neck

The charts of 102 patients with stage IV squamous cell carcinoma of the head and neck, seen at the East Orange Veterans Administration Hospital between 1975 and 1979, were reviewed. Ninety-one of these patients were submitted to a protocol of high-dose preoperative radiotherapy, followed by surgery. Five-year actuarial survival in patients completing the protocol was 31.6 per cent. All patients who completed radiotherapy and were eligible for surgery, but refusing operation, died of their disease within three years. Historical controls for stage IV head and neck cancer have five-year survival rates of 0-16 per cent, depending on site. A recent review of the literature shows stage IV lesions treated with surgery alone have a five-year survival rate of 6 per cent.