Standard Treatment If the tumor can be removed, similar considerations and methods to those for Stage III are used. If it can't, radiotherapy is used.
Chemotherapy and radiation sensitizers with the radiotherapy are under clinical evaluation. There are also radiotherapy protocols evaluating hyperfractionation schedules (more than one treatment daily).
Careful and frequent post-treatment follow-up is essential.
Five-Year Survival 15 to 25 percent
Recurrent Cancer If radiotherapy was originally used, the standard treatment is surgery if it is possible. If surgery was used originally, then radiotherapy is given unless previous radiotherapy dosage precludes additional treatment. Additional surgery may be possible. Chemotherapy protocols are under clinical evaluation.
