COMPLICATIONS FOLLOWING FAST-NEUTRON THERAPY FOR HEAD AND NECK-CANCER

Serious complications resulting from the use of fast neutrons to treat head and neck malignancies are reported in 38 patients. The average i nterval between treatment and onset of complications was 5.5 years. Si gnificant airways obstruction, requiring a tracheostomy, occurred in t wo patients, and a gastrostomy or pharyngostomy was performed for intr actable dysphagia in six. Eight patients developed osteoradionecrosis; carotid artery rupture occurred in three patients following surgery f or residual or recurrent disease. Our experience suggests that complic ations following fast neutron therapy for head and neck tumours are mo re severe, more common and occur after a longer time interval than tho se seen following conventional radiotherapy. Subsequent surgery in the irradiated area is compromised by severely impaired wound healing. Wh en radical surgery is necessary for residual or recurrent disease the entire volume of irradiated tissue must be removed if healing is to be achieved.