Functional results succeeding primary combined external radiotherapy and brachytherapy for head and neck tumors

Histologically proven radical resections often lead to severe functional problems especially in upper aero-digestive-tract tumors. Oncologically the combination of external radiotherapy and brachytherapy offers an alternative treatment option. The functional results and the complication rate in stage III and IV tumors of the oral tongue, floor of mouth and oropharynx are described in a patients series. The follow-up includes 17 consecutive patients who were primarily treated by a combination of external radiotherapy and brachytherapy between 1997 and 2000. The oncological benefit (complete remission, disease-free survival), the functional results (mastication, swallowing, speech and pain) and the complications were reviewed. After the follow-up period 16/17 patients were alive. There were 3 major complications, one of them lethal. The functional results resembled those after surgical resections. A combined radiotherapy is a feasible method of treating patients who refrain from surgery. Moreover the application ranges from inoperability to postoperative radiotherapy in cases with close or positive margins. In connection with neck-dissections and therapy of recurrent cancer major complications may occur. In contrast to the general opinion radiation therapy was not superior to surgical resection concerning functional sequelae.