title: Irradiation and free tissue transfer in head and neck cancer.
abstract: The aim of this study was to analyze the effects of surgery, irradiation, and free tissue transfer in locally advanced head and neck cancer patients. Forty-one patients with head and neck cancer were treated with surgery, irradiation, and free tissue transfer for reconstruction from 1977 to 1987. The age range was 38 to 78 years with a median age of 61. Patients were staged using the AJCC (1978) staging system. Eighty-four percent of the patients were in stage III or IV. The common sites of primary tumors were the oral cavity (22) and oropharynx (10). Forty patients had squamous cell carcinoma and 1 patient had basal cell carcinoma. Six patients had preoperative irradiation, and the rest had postoperative irradiation. The most common surgical procedures were partial glossectomy and neck dissection (17 patients) and wide excision of the primary and neck dissection (17 patients). The most common types of free tissue transfer were dorsalis pedis (13 patients) and scapular flaps (6 patients). The primary site was controlled in 22 patients (54%) and the neck in 36 patients (88%). Three patients (7.3%) had flap failure which required further surgical management. Eighteen patients are living with no evidence of disease with a median follow-up of 18 months (5-101 months), 10 patients are living with disease with a median follow-up of 9 months (3-40 months), 9 patients are dead of disease with a median survival of 13 months (6-54 months), and 4 patients are lost for follow-up. This study shows that free tissue transfer before or after irradiation is of benefit with few complications.
authors.affiliation: Department of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, KY 40202.
authors.forename: B
authors.initials: B
authors.lastname: Jose
authors.forename: J
authors.initials: J
authors.lastname: Banis
authors.forename: M
authors.initials: M
authors.lastname: Flynn
authors.forename: R
authors.initials: R
authors.lastname: Lindberg
authors.forename: W J
authors.initials: WJ
authors.lastname: Spanos
authors.forename: K
authors.initials: K
authors.lastname: Paris
authors.forename: J
authors.initials: J
authors.lastname: Rohm
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005927:Glossectomy; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000532:radiotherapy / Q000601:surgery; D009132:Muscles / Q000637:transplantation; D037981:Neck Dissection; D009367:Neoplasm Staging; D011182:Postoperative Care; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013524:Surgical Flaps; D015996:Survival Rate