Radiation therapy alone, surgery alone, or the combination of these two modalities, remain the accepted treatments in the management of epidermoid carcinomas of the mucosa of the head and neck. These modalities of therapy produce comparable results; but, radiotherapy alone has the advantage that it can conserve anatomy and function. Irradiation with teletherapy techniques, at times supplemented by interstitial brachytherapy, with doses ranging from 6600 to 8000 cCy, results in satisfactory tumor response (CR). The CR of TINO and T2NO lesions will be 99% and 90% respectively, but only 29% in T4N3 tumors treated with radiation only. To improve on the limited CR rate achieved in the advanced stages, surgery is combined pre or post-irradiation. or reserved for the salvage of failures. In the oral cavity and oropharynx, these possible options give comparable tumor control and survival, but in the supraglottic larynx post-operative irradiation is superior to pre-operative radiotherapy. Tumor recurrence rates in the head and neck range from 15 to 34% depending on initial site, stage and type of therapy. Cancer control activities that emphasize prevention and early diagnosis should present a better future for these patients.
Cancer 552259-2265. 1985.
PIDERMOID CARCINOMAS that originate in the mu-E cosa of the upper respiratory and digestive tracts, located in the head and neck, have common etiologic factors (excepting the nasopharynx), common clinical tendency to spread locally and to the neck nodes before developing distant metastases, and fairly uniform response to radiotherapy with or without the addition of surgery. Carcinoma of the lip will be excluded because of its favorable prognosis, as well as other primary neoplasms such as those occumng in the skin, eye, brain, bone. and soft tissue, and glandular tumors such as the ones that originate in the thyroid, salivary glands, etc.
In the anatomic area of reference we have a great diversity of sites and subsites. This results in variations in the initial symptoms and signs, clinical spread of tumor, staging classification, therapeutic implications, and response to therapy in the different anatomic locations. The incidence of nodal involvement and the