Therapeutic approach to head and neck carcinomas - surgery vs radiotherapy

The role and place of the two basic methods of treating head and neck carcinomas - surgery and radiotherapy - and the indications for their application, alone or in combination, are outline. The advantages of operation and radiotherapy, cervical relapse hazards, distant metastases, late complications, as well as the risk of second neoplastic localization are taken to be as factors having important practical implications on the adequate choice of therapeutic approach. Under a separate heading are considered the general principles underlying the treatment approach in compliance, with the patient's general condition, localization and stage of the pathological process. Finally the main indications for independent or combined application of surgery and radiotherapy are discussed, followed by detailed description of the indications for combined radiotherapy and operative management, including various pre- and postoperative radiotherapy protocols with recommended timing and dosage. Operative and radiation methods, used separately or in combination, account for control (cure) of most of the carcinomas involving head and neck. (author)