Radiation therapy for XXXX of the head and neck.

@entity1 @entity41 @entity5 @entity6311 @entity552 @entity3 @entity320
This report reviews experience with radiation therapy in 77 @entity1 with @entity320 of the head and neck, a lesion traditionally but incorrectly considered to be radiation-resistant. Thirteen @entity1 with @entity6311 and 18 @entity1 with @entity6311 @entity320 have been primarily irradiated. In 11 of the 13 @entity1 , the @entity6311 has been locally controlled with no recurrence from 6 months to 5 years following treatment. One @entity1 had a local recurrence and was salvaged with further radiation therapy, and one @entity1 had @entity41 after irradiation and was salvaged with simple excision. Seventeen of 18 @entity1 primarily irradiated had @entity6311 @entity320 that have been locally controlled from 6 months to 6 years after irradiation. One @entity1 had a local recurrence and was salvaged by excisional surgery. There have been no deaths from lentigenous @entity320 , and the cosmetic results of treatment are excellent. We concluded that radiation therapy is a simple, effective out- @entity1 treatment for @entity552 and @entity320 . Nonlentigenous @entity320 was irradiated after incisional biopsy in 6 @entity1 ; local control was obtained in 4 @entity1 although 1 died of distant @entity3 . Fifteen @entity1 were irradiated after excisional biopsy (margins inadequate); 14 of 15 had local control although 6 died of @entity3 . Only 2 of 16 @entity1 irradiated for recurrent @entity320 were controlled. Analysis of local control versus irradiation fraction size revealed that 17/24 (71%) achieved local control with a dose per fraction of greater than 400 rad as compared with 3 of 12 (25%) in those being irradiated with a dose of less than 400 rad per fraction. We concluded that nonlentigenous @entity320 is not radiation resistant and that local excision followed by radiation therapy with a large dose per fraction deserves further study, particularly in @entity320 of the head and neck where wide local excision is not possible due to age of the @entity1 or location of the @entity5 . Nine @entity320 have primarily irradiated and four have been locally controlled.
