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May 1974

Radiation Necrosis

Author Affiliations

Consultant Radiotherapist Ear, Nose, and Throat Infirmary Liverpool, England

Arch Otolaryngol. 1974;99(5):393. doi:10.1001/archotol.1974.00780030405018

To the Editor.—We would be grateful if we could be allowed to clarify two statements in the recent article on "Radiation Necrosis of the Larynx" by Stell and Morrison.1

It is certainly readily appreciated in the Liverpool Radiotherapy Unit that it is desirable to treat a patient over a longer period than three weeks, and indeed, only circumstances beyond our control (eg, numbers of available beds to serve a scattered population of nearly 3 million) have until recently frustrated this.

The increased field sizes quoted in a minority of the necrotic cases were necessitated by (1) extent of disease and (2) presence of metastatic nodes. In these cases, the total tumor radiation dose was somewhat reduced. Field sizes of 5 × 5 cm (maximum) are the norm in the great majority of cases.

Radiotherapists and laryngologists alike are aware of the problems associated with the treatment of laryngeal

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