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Complications following fast neutron therapy for head and neck cancer

Published online by Cambridge University Press:  29 June 2007

N. Stafford ,
J. Waldron ,
D. Davies ,
G. Walsh-Waring  and
R. Smith
N. Stafford*
Affiliation:
Department of ENT, St Mary's Hospital, London W2
J. Waldron
Affiliation:
Department of ENT, St Mary's Hospital, London W2
D. Davies
Affiliation:
Department of Plastic Surgery, St Mary's Hospital, London W2
G. Walsh-Waring
Affiliation:
Department of ENT, St Mary's Hospital, London W2
R. Smith
Affiliation:
Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead, Sussex
*
Mr N. Stafford, F.R.C.S., Consultant ENT Surgeon, St Mary's Hospital, Praed Street, London W2 1NY.
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Abstract

Serious complications resulting from the use of fast neutrons to treat head and neck malignancies are reported in 38 patients. The average interval between treatment and onset of complications was 5.5 years. Significant airways obstruction, requiring a tracheostomy, occurred in two patients, and a gastrostomy or pharyngostomy was performed for intractable dysphagia in six. Eight patients developed osteoradionecrosis; carotid artery rupture occurred in three patients following surgery for residual or recurrent disease.

Our experience suggests that complications following fast neutron therapy for head and neck tumours are more severe, more common and occur after a longer time interval than those seen following conventional radiotherapy. Subsequent surgery in the irradiated area is compromised by severely impaired wound healing. When radical surgery is necessary for residual or recurrent disease the entire volume of irradiated tissue must be removed if healing is to be achieved.

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 106 , Issue 2 , February 1992 , pp. 144 - 146
Copyright
Copyright © JLO (1984) Limited 1992

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