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February 1982

Radiation Therapy for Subclinical Carcinoma in Cervical Lymph Nodes

Author Affiliations

From the Departments of Radiology (Drs Mantravadi and Liebner and Mr Haas) and Otolaryngology (Drs Katz, Sabato, Skolnik, and Applebaum), University of Illinois Hospital and Eye and Ear Infirmary, Chicago.

Arch Otolaryngol. 1982;108(2):108-111. doi:10.1001/archotol.1982.00790500044010

• Radiotherapy alone was used to treat 187 patients with a head and neck cancer and clinically uninvolved lymph nodes. Delayed lymph node metastases developed in 35 (19%) patients, and concomitant tumor at the primary site was present in 90% of them. In two (1%) of the 187 patients, delayed metastases developed in the irradiated nodes with the primary tumor controlled; both of these patients received a radiation dose of less than 5,000 rad. Metastases in supraclavicular and posterior cervical regions occurred in 4% of the patients; and these sites were not included in the original radiation fields. The following conclusions were reached: (1) a radiation dose of 5,000 rad or more can eradicate 99% of the subclinical carcinomas in lymph nodes; (2) whole-neck irradiation is not indicated in patients with No stage tumor; and (3) surgical resection of primary tumors alone, without added neck dissection, may be adequate if postoperative radiation therapy is planned.

(Arch Otolaryngol 1982;108:108-111)

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