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Between 1973 and 1977, 254 patients with previously untreated squamous cell carcinoma of the larynx received 60Co external beam therapy; 161 patients (63.4%) survived without evidence of malignancy for five years after the radiation therapy alone, and 21 patients survived after salvage surgery. The overall crude survival rate was 182/254, i.e. 71.7 per cent at five years. Five-year survival rates without evidence of malignancy were 81.6 per cent in stage I, 73.4 per cent in stage II, and 40.8 per cent in stage III.

Over the years 1986–1997, at the Centre of Oncology in Kraków, 82 patients (28 women, 54 men; mean age: 50.8 years) with poorly differentiatied naso- and oropharyngeal carcinoma with metastases to regional nodes (stage III and IV) received neoadjuvant chemotherapy followed by teleradiotherapy. The primary tumour was located in the nasopharynx in 57 patients (69.5%), in the tonsil – in 24 (29.3%), and in the base of the tongue (one patient). Chemotherapy cycles consisted of cisplatin in a dose of 100 mg/m2administered intravenously on the first day, and 5-f1uorouracil in a dose of 1000 mg/m2over days 1 to 5. Forty-seven (57.3%) patients received 3 cycles, 25 (30.5%) patients – 2 cycles, 8 (9.8%) patients – 1 cycle. After chemotherapy, patients received conventionally fractionated (200 cGy 5x a week) radiotherapy to the primary tumour (50–65 Gy) and regional nodes (50–70 Gy). The therapy was generally well tolerated, however two patients developed fatal late complications. Improvement in therapy results was observed when comparised with a historical group. Five-year overall survival was 52%. The degree of regression (PR + CR), following neoadjuvant chemotherapy, which appeared to depend on the number of chemotherapy cycles, is the main prognostic factor for this group of patients.

The clinical results of reirradiation with 60Co of recurrences of head and neck cancer in 20 patients are presented. Fourteen patients, i.e.70%, survived three years after reirradiation and ten patients, i.e.50%, were symptom-free. Necrosis developed in four patients (20%). Reirradiation seems to be valuable and a relatively safe treatment of patients with inoperable recurrences of head and neck cancer.

One hundred and forty-one patients with poorly differentiated naso- and oropharyngeal carcinoma were treated at the Center of Oncology in Krakow 1970-1985. Ninety-eight patients, treated from 1970 to 1980, received radiation therapy alone and forty-three patients, treated from 1981 to 1985, received adjuvant monochemotherapy with methotrexate 60 mg/m2 i.v. administered every 6 weeks, starting 6 weeks after completion of radiotherapy. The two groups were comparable in patients' characteristics such as stage of the disease, sex, age, localization and histology. The three-year survival rate in the total group of 141 patients was 46.8%. Important prognostic factors were: stage (UICC 1987). extent of local tumour and nodal involvement. Three-year survival rates according to stage were as follows: stage I, 100%; stage 11, 95%; stage 111, 75% stage IV, 4.4%. There was no significant survival difference between the two groups, and the adjuvant methotrexate therapy did not alter the pattern of failures. The results do not support the hypothesis that adjuvant methotrexate treatment is beneficial in this type of patient.