[Value of irradiation of neck nodes metastases. Part I. Treatment of palpable nodes].

Medical records of 222 patients with neck nodes metastases from squamous cell carcinoma of supraglottic larynx (122 cases), tonsil (63 cases) and base of tongue (37 cases) were analyzed. All cases were treated with definitive irradiation between 1970-1981. One hundred ten patients were treated with orthovoltage technique with total doses of 5000-6000 rads, 150-180 rads per fraction; 112 patients with Co60 with total doses 6000-7000 rads, 180-230 rads per fraction. Local-regional control was achieved in 28% of cases. Failures in the neck nodes with primary tumour controlled, were recorded in 10% of patients. Failures in a primary tumour alone were observed in 26% of patients, in primary tumour and neck nodes in 36%. Radiocurability of primary tumour and involved neck nodes was similar. In cases with primary tumour controlled, the probability of eradication of neck nodes metastases is high, even in N3 stage patients. Residual neck nodes palpable 1 to 3 months after irradiation were unfavourable prognostic factor indicated 50% risk of neck recurrence. In patients with complete regression of primary and nodal disease, failure in neck nodes was recorded in 5% of cases. The role of surgery following irradiation in patients with cervical nodes metastases is discussed.