[Radiotherapy of ENT tumors and risk of lymphedema]

Radiotherapy is a useful tool in the treatment of head and neck cancer either in an adjuvant or in a palliative setting. The tolerance doses of many tissues are near or even lower than the necessary therapeutic doses. Therefore some side effects of radiotherapy are unavoidable, others can be reduced if special technics are applied. Lymphedema of the head and neck is more often caused by radical surgery than by radiotherapy. If a combined modality treatment is used with surgery and radiotherapy, it results in an increased risk of lymphedema. If lymphedema results from radiotherapy it is caused by the late reaction of blood vessels and connective tissue within the irradiation field. Direct irradiation effects on lymphatic vessels are less important. Finally we stated four rules for the practical management of patients with visible lymphedema or the risk of developing an edema.