title: The morbidity of salvage surgery following conventional radiotherapy and continuous, hyperfractionated accelerated radiotherapy (CHART).
abstract: A comparison was made of the morbidity of surgery for loco-regional recurrence in patients with advanced cancer of the head and neck region following continuous hyperfractionated accelerated radiotherapy (CHART), after conventional radiotherapy, and also in a group following surgery only as the primary treatment. Post-surgical morbidity occurred in 14 (77%) of the 18 patients treated with CHART, of whom 11 (78%) required a further surgical procedure. In the conventional group, morbidity occurred in 14 (58%) of the 24 patients, of whom 9 (64%) required further surgery. Finally, in the surgical group morbidity occurred in 13 (48%) of the 27 patients, of whom 7 (54%) required further surgery. Because of the many factors that may influence the chance of morbidity and of the small number of cases, considered statistical analysis is not meaningful and there must be caution in the interpretation of results. When allowance is made for the greater frequency of more advanced tumors and for sites in the oropharynx and oral cavity, where procedures associated with greater risk of complication were performed, the morbidity seen after surgery was performed upon CHART patients appeared to be no greater than when conventional radiotherapy had been given. As expected, the surgery only group showed less morbidity than either of the radiotherapy groups.
authors.affiliation: Regional Center for Radiotherapy and Oncology, Mount Vernon Hospital, Northwood, Middlesex, UK.
authors.forename: T
authors.initials: T
authors.lastname: Rugg
authors.forename: E
authors.initials: E
authors.lastname: Lartigau
authors.forename: R
authors.initials: R
authors.lastname: Sanders
authors.forename: G
authors.initials: G
authors.lastname: Glover
authors.forename: M I
authors.initials: MI
authors.lastname: Saunders
authors.forename: S
authors.initials: S
authors.lastname: Dische
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011879:Radiotherapy Dosage; D014945:Wound Healing