Head & neck
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Between March 1978 and March 1989, 419 patients with 439 moderately advanced or advanced primary squamous cell carcinomas of the head and neck received treatment with curative intent with twice-a-day radiotherapy (120 cGy per fraction with a 4- to 6-hour interfraction interval). Seventy-nine percent of the patients had AJCC stage III or stage IV cancers. The primary site in most patients was the oropharynx, hypopharynx, or larynx. ⋯ Local control results were compared on a site-by-site and stage-by-stage basis with the results of continuous-course, once-a-day radiotherapy at the University of Florida; the control results were the same as or better than after once-a-day radiotherapy for each site and stage (T2 to T4). Severe complications of radiotherapy occurred in 4% of patients and correlated with tumor dose, T stage, and disease site (oropharynx or larynx/hypopharynx). The addition of a neck dissection 4 to 6 weeks after radiotherapy of patients with advanced-stage neck disease was accomplished with an acceptable rate of morbidity and significantly improved the rate of control of neck metastases compared with radiotherapy alone.