Elective postoperative radiation therapy in stages III and IV epidermoid carcinoma of the head and neck.

One hundred five patients with advanced (American Joint Committee stages III and IV) but resectable epidermoid carcinoma of the head and neck were treated with radical surgery and elective postoperative radiation therapy. Follow-up periods range from 16 to 66 months. Nineteen patients (18 percent) have had recurrence in the head and neck area. This is better than our past experience with surgical treatment alone in advanced head and neck cancer, in which 50 to 75 percent of patients had local recurrence within the 1st 18 months. When radiation therapy was started no later than 6 weeks after surgery, only 3 of 54 patients (5.5 percent) had local recurrence, but when there was a longer delay 16 of 51 patients (31.5 percent) had recurrence. These results suggest that elective postoperative radiation therapy improves local control in patients with advanced head and neck cancer, but that it should be delivered soon after surgery for maximum effectiveness.