IT HAS been estimated that at least 60,000 patients die each year from our inability to control cancer while it is still localized at or near its site of origin.1 This disappointing failure to control local cancer with surgery alone, or with radiation therapy alone, has led to many clinical trials that combine these two modalities. In their search for optimum sequencing and technique, proponents of combined forms of therapy have been acutely aware of the fact that halftreatment with radiotherapy and half-treatment with surgery can rarely be combined to produce control rates equal to the more radical application of either method alone. Because of this fact, it is understood that the combination of the two methods usually calls for high-dose radiotherapy and a surgical procedure not too different from that recommended if no radiotherapy has been given.
Rationale of Combined Radiation Therapy and Surgery
There are a variety
Stevens KR, Moss WT. Control of Localized CancerCombination of Preoperative Irradiation and Surgery. JAMA. 1975;232(11):1158–1160. doi:10.1001/jama.1975.03250110040023