Role of radiation therapy in the multi-modal treatment of head and neck cancer

The role of radiation therapy as part of the multi-modal treatment of head and neck cancer appeared to be important with respect to functional and cosmetic morbidity. As for oral cancer, the value of brachytherapy was excellent in cases of localized disease. As far as the latter technique was applicable, patients with tongue cancer at T1, T2 and T3 could be treated by radiation as the initial choice unless palpable neck node metastasis was present. In contrast, cure of the lesion would not be expected from external irradiation alone even when combined with chemotherapy. Accordingly, in such advanced cases, salvage surgery should be applied with or without radiation and/or chemotherapy. As for maxillary cancer, the introduction of ''trimodal therapy'' has improved the local control rate only to a slight degree. After the application of conservative surgery followed by conventional trimodal combination therapy, local control and five-year survival rates have been improved markedly. (author)