[Radiotherapy of malignant tumors of the maxillofacial region].
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The treatment philosophy of carcinoma of the oral cavity is explained. Specific guidelines for therapy of various head and neck sites are offered as a rational approach to formulation of individual treatment programs.
The management of recurrent head and neck malignancy can be one of the most frustrating experiences faced by the head and neck surgeon. A recent study indicates that twice the number of patients succumb to distant metastasis from primary tumors than did 20 years ago. This article discusses the operative management of these patients and the role of radiotherapy and chemotherapy in their treatment.
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Precancerous lesions of the oral cavity and the larynx are usually treated by surgery, because a complete histological examination for detecting an invasive carcinoma is important and, on the other hand, modern surgery procedures yield very satisfactory functional results. High-dose irradiation of inoperable high-risk precancerous lesions of the larynx may be taken into account. Experiences in the irradiation of inoperable low-risk lesions with different doses are very rare. The carcinoma in situ should be treated like an invasive carcinoma. 10 years of experience in radiotherapy of precancerous lesions of the larynx in 23 patients are reported.
One hundred thirty-seven patients with non-small cell lung cancers, 57 with oral cavity cancers and 98 with postoperative breast cancers treated with external radiotherapy from 1974 to 1980 were analyzed to determine optimal trends of time-dose relationships. Superiorities of fractionation factors were examined by comparing the relative local recurrence or expire rates among the subgroups prognostically homogenized in each entities of the diseases. Favorable fractionation factors for the former two diseases were those in which treatment was given in shortened over-all times, and frequently with low fraction dose to the considerably high daily dose. These results indicate the superiority of accelerated fractionation regime to conventional one in the treatment of those diseases. In contrast, any optimal trend was not found with postoperative breast cancers but total dose administered more than 43 Gy.
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