Applications of carbon dioxide laser surgery and radiation. A preliminary report.

Ten patients with advanced or recurrent squamous cell carcinomas of the upper airway were treated with a combination of carbon dioxide laser surgery and radiation therapy to evaluate the tolerance to rapid sequencing of both modalities in a variety of clinical situations. Other considerations were to accurately stage infiltrating tumors, to provide cytoreduction for T3 and T4 tumors, and to facilitate the optimal placement of intracavitary radium applicators. Because of minimal postoperative pain or dysfunction associated with the laser, patients were able to receive irradiation considerably sooner than with conventional surgery.

Diagnosis of infratemporal fossa tumors using percutaneous core needle biopsy.

Three patients with infratemporal fossa carcinomas presented with severe, unrelenting facial pain, weight loss, and 5th cranial nerve deficit. Erosion of the base of the skull at the foramen ovale was present in two of these patients. Histologic diagnosis of infratemporal fossa malignancy was obtained by needle biopsy of the foramen ovale region; the technique is described.

Induction chemotherapy in advanced squamous head and neck carcinoma with high-dose cis-platinum and bleomycin infusion.

Forty patients with advanced head and neck cancer were treated with combined Cis-platinum-Bleomycin chemotherapy. Cis-diammine dichloroplatinum (DDP) 120 mg/m2 iv was given after prehydration, with mannitol diuresis on Day 1. On Day 3, an initial loading dose of Bleomycin 15 mg/m2 was given by rapid iv push followed by continuous 24 hour intravenous infusion of Bleomycin 15 mg/m2 Day 3 through Day 10.

A randomized trial of preoperative radiotherapy in cancer of the oropharynx and hypopharynx.

One hundred patients with stage II and stage III cancer of the oropharynx and hypopharynx were treated under a protocol in which they were randomly selected for treatment by surgery alone or by combined preoperative radiotherapy and surgery. The schedule of preoperative radiation therapy chosen was 2,000 rads from a cobalt 60 machine delivered in five days. Eighty-six of the patients were evaluable at three years; there was no difference in the outcome of the treatment of the two groups.

Treatment of squamous cell carcinoma of the floor of the mouth.

Treatment of 88 selected patients with Stages I and II squamous cell carcinoma of the floor of the mouth by monobloc resection has produced a high five year cure rate. The death of one patient in the series postoperatively was considered a surgical one. Disability after such a procedure is minimal, and dental complications are not a factor.