An evaluation of elective irradiation of neck nodes in patients with cancer of the supraglottic larynx.
Between 1964 and 1973, 152 patients with supraglottic cancer limited to the larynx with clinically negative neck were included in the controlled randomized study designed to evaluate elective irradiation of the neck. The patients were randomized to one of the 2 treatment groups: 1) "T+N": irradiation of the larynx and all neck nodes, tumor dose 5130 rad/6-7 weeks, 2) "T": irradiation of the laryngeal portals only, tumor dose 5130 rad/5 weeks. All patients received 250 kV orthovoltage irradiation. The biologic dose delivered to the larynx was greater in group "T" because of faster fractionation and shorter overall time of therapy. The calculated NSD value for the patients in group "T+N" varied from 1620 to 1690 ret, and in group "T" it was 1800 ret. Five-year survival rates with a preserved larynx and without cancer were 45.3% for group "T+N" and 66.2% for group "T". Seven patients of group "T" developed metastatic cancer in the neck, and 4 of them were cured by neck dissection. It is concluded that patients with early supraglottic cancer can be successfully irradiated through laryngeal portals only, including the larynx, and possibly midjugular and digastric nodes. The tumor dose should be at least equivalent to the NSD of 1800 ret in the condition of megavoltage therapy.
D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D002986:Clinical Trials as Topic; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy*; D008198:Lymph Nodes / Q000528:radiation effects*; D008207:Lymphatic Metastasis / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009333:Neck; D011829:Radiation Dosage; D011897:Random Allocation