CONTROL BY IRRADIATION ALONE OF NONFIXED CLINICALLY POSITIVE LYMPH NODES FROM SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY, OROPHARYNX, SUPRAGLOTTIC LARYNX, AND HYPOPHARYNX

The records from 1948 through 1967 of 344 previously untreated patients with squamous cell carcinoma of the oral cavity, oropharynx, supraglottic larynx and hypopharynx who had clinically positive cervical lymph node metastases staged N1, N2A, or N2B, and whose initial neck treatment consisted of ex...

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Published inAmerican journal of roentgenology (1976) Vol. 123; no. 1; pp. 42 - 48
Main Authors SCHNEIDER, JACK J, FLETCHER, GILBERT H, BARKLEY, H. THOMAS, JR
Format Journal Article
LanguageEnglish
Published United States Am Roentgen Ray Soc 01.01.1975
Subjects
Carcinoma, Squamous Cell - radiotherapy
Carcinoma, Squamous Cell - surgery
Cobalt Radioisotopes - therapeutic use
Humans
Laryngeal Neoplasms - radiotherapy
Laryngeal Neoplasms - surgery
Lymph Node Excision
Lymph Nodes - radiation effects
Lymphatic Metastasis - radiotherapy
Mouth Neoplasms - radiotherapy
Mouth Neoplasms - surgery
Neck
Pharyngeal Neoplasms - radiotherapy
Pharyngeal Neoplasms - surgery
Radiation Dosage
Radiation Effects
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Summary:The records from 1948 through 1967 of 344 previously untreated patients with squamous cell carcinoma of the oral cavity, oropharynx, supraglottic larynx and hypopharynx who had clinically positive cervical lymph node metastases staged N1, N2A, or N2B, and whose initial neck treatment consisted of external radiation therapy alone were reviewed. After appropriate exclusions the study group consists of 183 patients. The dose to the lymph node(s) was calculated retrospectively. The control rates for N1 lymph nodes are 91.5 per cent (76/83) and for N2 lymph nodes 78.5 per cent (55/70) in the patients whose lymph node(s) were well included in the irradiated volume and received a known dose. A dose response analysis shows that doses in the range of 6,500 rads to a single lymph node, 3 cm. or less in diameter, produce 90 per cent control. When a nonfixed metastatic lymph node of 3 cm. or more in diameter of multiple lymph nodes are present or there is questionable coverage, external irradiation alone cannot be relied upon for control and a neck dissection should follow.
ISSN:0361-803X
0002-9580
1546-3141
DOI:10.2214/ajr.123.1.42