Abstract
Tumors in the head and neck are treated in the majority of cases by surgery and/or radiation therapy (RT). If the primary cancer is irradiated, conceptually a high dose of RT is to be given, particularly if one is dealing with large T3 or T4 tumors. The RT can be given by external beam irradiation (ERT) or interstitial radiation therapy (IRT). In the Dr. Daniel den Hoed Cancer Center (DDHCC), patients with deep-seated advanced and/or recurrent tumors in the head and neck are in some instances treated by a combination of ERT and (subsequent) IRT (Levendag et al. 1992). When using IRT, high tumoricidal doses of RT can be applied while attempting to compromise the surrounding normal tissues as little as possible. Unfortunately, when RT doses in the order of 70–80 Gy are applied, failures do occur even if the RT is tailored to the primary cancer to the greatest extent possible by means of interstitial techniques; more over, the side-effects of such high doses of RT can be substantial.
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