One to six years after treatment for head and neck cancer, 68 patients were asked to fill in a questionnaire at home with a subsequent examination at the out-patient clinic of the Ullevål University Hospital. 50 patients (74%) both answered the questionnaire (the EORTC QLQ-C30, a diagnosis specific questionnaire module, the GHQ-20, and two questions from a population survey) and presented for examination where the clinician rated side effects after treatment, and filled in the Karnofsky Performance Status and the Spitzer's Quality of Life index. No patients had relapse or second primary tumours at the time of examination but a variety of post-treatment side effects were recorded. The patients appeared to report lower quality of life including more post-treatment side effects compared with the clinician's assessments. The cost-benefit of the standard clinical follow-ups in terms of increased survival may be questioned. Patients seem to need better support in coping with the physical and psychosocial problems which often appear.

Two groups of patients were compared. In group 1, consisting of 304 patients treated from 1958 to 1972 (minimum observation time of 5 years), the local and regional control rate was 35 per cent. In group 2, consisting of 126 patients treated 1978 to 1983 (median observation time of 58 months), the local and regional control rate was 60 per cent (p less than 0.0001). The local and regional control rates were improved for all stages, but the differences were significant only for stages T1N0, T2N0, T3N0 and TXN2,3. The actuarial survival rates also showed improvement in group 2 patients. The incidence of treatment failure, with regard to the neck alone or tongue and neck combined, decreased from 51 per cent to 27 per cent with the newer techniques. The greatest improvement was observed in patients with T1N0 and T2N0 tumors. There was also a decrease in the failure rates in patients with the more advanced tumors.