An evaluation of fast neutron beam teletherapy of metastatic cervical adenopathy from squamous cell carcinomas of the head and neck region.

One hundred thirteen patients with metastatic cervical adenopathy (MCA) from advanced squamous cell carcinoma of the head and neck completed fast neutron beam irradiation between September 1976 and March 1977. With a maximum follow-up time of 49.9 months (mean 14.5 months), 54% of the total group remain disease-free at the sites of their cervical adenopathy. Control of adenopathy measuring 3 cm or less in maximum dimension was 75% with neutrons only and 87.5% with mixed beams. Nodes measuring 3-6 cm were controlled 38.1% of the time with neutrons only and 59% of the time with mixed beams. Clinical control of adenopathy measuring greater than 6 cm was obtained in 12.5% with neutrons only and 29.4% with mixed beams. For patients with controlled primary tumors, the overall control rate in the neck was 72%; 100% of nodes 3 cm or less were controlled, 82% of nodes measuring from 3-6 cm were controlled, and 42% of nodes greater than 6 cm were controlled. Patients with controlled primary tumors treated with mixed beams had 100% control of nodes measuring 3 cm or less, 96% control of nodes measuring 3-6 cm, and 50% control of nodes measuring greater than 6 cm. Overall, the control rate for mixed beams was significantly better than for treatment with neutrons only. Morbidity was less (both acute and late) in the mixed beam-irradiated group.