Complications of Combined Surgery and Neutron Radiation Therapy in Patients with Advanced Carcinoma of the Head and Neck

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Abstract
Patients (135) with advanced squamous-cell carcinoma of the head and neck were treated with cyclotron-generated fast neutrons. Thirty-eight patients had major surgery before or after irradiation. Major complications (fistula formation, carotid artery exposure or blowout requiring ligation, or major wound breakdown) occurred in 37%. The complication rates associated with surgery prior to irradiation, planned surgery following irradiation and salvage surgery following irradiation were 0 of 12, 4 of 5 and 10 of 21, respectively. The complication rate for surgery following neutron irradiation alone was 73%; for surgery following mixed-beam irradiation it was 20%. The age of the patient and the interval between surgery and irradiation had no influence on the complication rate.