Re-irradiation of recurrent head and neck cancer with fast neutrons.

Abstract

Recurrent inoperable cancer of the head and neck after a full course of radical radiation therapy is a major challenge to all radiation oncologists. According to Marcial and Pajak (1985), after radiation therapy for head and neck cancer 21% of treated patients had locally persistent tumour and 18.8% developed recurrence at the primary site within 5 years. In our previous study, the results of irradiation with 60Co teletherapy in 20 patients with recurrent head and neck cancer were presented (Skolyszewski et al, 1980). As 10 out of 20 of those patients survived without evidence of disease for at least 3 years after the second course of radiation therapy, the irradiation of recurrent head and neck cancer has become standard policy at our institution, providing the patient is not qualified for rescue surgery, the surface of treatment fields does not exceed 50 cm2, and the interval of time between the two courses of therapy is at least 6 months. Looking for a way of improving the results, in 1979 we started re-irradiating the patients with more advanced recurrent tumours of the head and neck with fast neutrons. This paper discusses the value of this procedure.