Prophylactic neck irradiation.

Treatment of subclinical cervical metastases from advanced squamous carcinomas of the nasopharynx, oropharynx, oral cavity, hypopharynx, and larynx remains contentious. Watchful waiting, elective neck surgery, and, more recently neck irradiation all have their advocates. The possibility of "sterilization" of the neck showing no clinical signs of metastasis has been especially appealing in concept. Wth this in mind, and by use of an external high-dose megavoltage technique, radiation therapy was used in 152 patients with clinically negative necks at the Upstate Medical Center from 1968 to 1977. Lymph node failures were extremely low (4%) when wide-field radiation ports were used and the primary lesion controlled.