Which among the following is the best treatment modality for a man with T4 N0 M0 stage of head and neck carcinoma?
T4 N0 M0 indicates stage 4A. That means there is no regional lymph node metastasis and distant metastasis. The standard treatment for advanced (stage III and IV) head and neck cancer is surgery followed by postoperative radiation therapy. For T1 and T2 (with N0M0) either of surgery or radiotherapy can be used with equal results. Ref: Head and Neck Cancer: Emerging Perspectives By John F. Ensley, 2003, Page 27; Head and Neck Cancer: Multimodality Management edited by Jacques Bernier, 2011, Page 383; Schwaz's Principles of Surgery, 9th edition, Chapter 18 ; Disorders of the Head and Neck, Bailey & Love's, 25th edition, Page 740
Surgery alone
Radiotherapy alone
Chemoradiation
Surgery and Radiotherapy