The contemporary management of patients with cancers of the head and
neck is under careful scrutiny and major changes are being introduced in
order to improve the potenti- al not only for long-term control but also
for less in the way of disfiguring and distres- sing complications
associated with the treatment programs. In 1988, the American Cancer
Society estimates that there will be 42400 new cases of malignant tumors
of the head and neck diagnosed with 12 850 deaths. In general, the
prognosis for patients with malignant tumors of the head and neck re-
gion depends upon the site of origin, the local and regional extent of
the tumor, the Kar- nofsky status of the patient as well as the
patient's general medical condition. The poten- tial for cure for early
stage tumors is extremely high particularly for those lesions involving
the vocal cord, oral cavity, and the anterior two-thirds of the tongue.
Major advances have been made in the management of head and neck cancer
by the innovative utilization of surgery with radiation therapy. Small
tumors can be cured by ei- ther surgery or radiation therapy with
equally good results. However, far advanced tu- mors are more
complicated and more difficult to cure requiring combined, integrated,
multimodal programs of management. Therefore, the previously general
poor prognosis for advanced tumors is becoming better with more
aggressive treatment regimens.