Standard Treatment High-dose radiotherapy to the primary area and the neck. Neoadjuvant chemotherapy (before radiation) is used as in Stage III. Surgical neck dissection is done for persistent or recurrent enlarged lymph nodes .
Five-Year Survival 5 to 40 percent
Recurrent Cancer Selected patients may be given additional radiotherapy, both external beam and implants. Some may be candidates for surgical removal of recurrent tumors.
Metastatic disease and local recurrences not treatable by surgery or radiation may be treated with chemotherapy. Clinical trials are evaluating chemotherapy as well as interferon.
