Radiation Therapy for Subclinical Carcinoma in Cervical Lymph Nodes

Incidence of contralateral regional failure in the electively irradiated contralateral neck of patients with head and neck squamous cell carcinoma

“…Although numerous studies reported on outcome of patients with HNSCC primarily treated with (chemo)radiation, studies on the incidence of RF in electively treated neck levels are scarce. In the seventies and eighties, different studies reported 1–8% incidence of RF in an electively treated neck [3] , [22] , [23] , [24] , [25] . However, the findings from these studies are barely applicable to the current clinical practice since these patient populations were treated with outdated 2-dimensional radiation techniques which are nowadays rarely used for the treatment of HNSCC, and these studies were published before the introduction of consensus guidelines for the delineation of the lymph node levels in HNSCC [20] .…”

Postoperative Radiotherapy for Persistent Tumor at the Surgical Margin in Head and Neck Cancers

“…Furthermore, a 5000-rad dose given over 5 weeks was shown to control microscopic tumor extensions from squamous cell cancers of upper aerodigestive tract in over 90 % of patients. "' 14 Therefore, we currently use a 5000-rad dose in patients with adequate tumor margins and with limited lymph node involvement, if radiotherapy can be initiated within 6 weeks after surgery. When a delay of greater than 6 weeks is unavoidable, the radiation dose is carried to 6500 rads over 6 'Ii to 7 weeks even if tumor-free margins were achieved.…”

Management of cervical metastasis

“…As with neck dissections, radiation portals are determined by the site of the primary tumor and the predicted drainage patterns. Mantravadi et al [42], in 1982, concluded that 5000 cGy or more of radiation can eradicate 99% of subclinical carcinoma in lymph nodes.…”