Nonsurgical treatment of advanced metastatic cervical disease in cancer ofthe larynx

Historically, patients with advanced cervical adenopathy (N2 or N3) have be tween a 20 and 30% chance of surviving their disease at 5 years from treatm ent. Despite attempts at more aggressive surgical resection, including rese ction and reconstruction of the carotid artery, patients with advanced cerv ical adenopathy remain at the highest risk for the development of local rec urrences and distant metastases, This chapter will review the current limit ations of surgical resectability for advanced neck disease, discuss the evo lution of combined chemoradiation therapy for these patients, and finally p resent promising recent technological advances in radiation oncology which will have significant impact on the treatment of these patients. Copyright (C) 2000 S. Karger AG, Basel.