Anatomical coverage in elective irradiation of the neck for squamous cell carcinoma of the oral tongue
From January 1954 through December 1978, 146 patients with squamous cell carcinoma of the oral tongue and clinically negative neck had their primary lesion controlled with irradiation. Metastases to the neck developed later in: 27 of 76 patients (36%) treated by interstitial implantation: nine of 27 patients (33%) who received 2,000 rad in five fractions to the upper neck prior to the implant; eight of 19 (42%) patients who received 5,000 rad through an upper ipsilateral neck field prior to the implant; four of 24 patients (16.6%) who received 5,000 rad through bilateral portals to the upper neck with or without irradiation of the lower neck. In the 43 ipsilateral neck failures, 23 were in the upper jugular chain, (posterior subdigastric nodes), 12 in the mid-jugular, three in the lower jugular, and four in the more anterior part of the subdigastric area. There was one failure in the posterior cervical chain, and five contralateral neck failures. A review of the treatment charts showed that the patients who had ipsilateral upper neck field only, had smaller portals because the irradiation was tailored to produce shrinkage of the primary tumor prior to needling. To include adequate coverage of the posterior subdigastric nodes (upper jugular), the bodies of the vertebrae must be seen on the simulator films. Also the junction of the subdigastric and the mid-jugular lymphatics must be covered. Although there were only three failures in the lower jugular nodes, it is technically easier to treat the upper mid-jugular nodes through an anterior appositional portal to the lower neck. A dose of 5,000 rad must be given since 2,000 rad, even if delivered in five fractions, gives a failure rate as if there had been no irradition to the neck.
- Research Organization:
- M.D. Anderson Hospital and Tumor Inst., Houston, TX
- OSTI ID:
- 5241642
- Journal Information:
- Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 8:11
- Country of Publication:
- United States
- Language:
- English
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63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
CARCINOMAS
RADIOTHERAPY
LYMPH NODES
FRACTIONATED IRRADIATION
NECK
METASTASES
TONGUE
RADIATION SOURCE IMPLANTS
PATIENTS
RADIATION DOSES
REVIEWS
BODY
BODY AREAS
DIGESTIVE SYSTEM
DISEASES
DOCUMENT TYPES
DOSES
IMPLANTS
IRRADIATION
LYMPHATIC SYSTEM
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORAL CAVITY
ORGANS
RADIATION SOURCES
RADIOLOGY
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)
560151 - Radiation Effects on Animals- Man