Regional Lymph Node Irradiation

  • J. T. Parsons
  • R. R. Million
  • W. M. Mendenhall
Conference paper
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 134)


When the lymph ondes are clinically negative (NO) and the risk of subclinical disease is 10%–15% or greater, the lymph nodes are included in the treatment portals and receive a minimum dose equivalent to 4500 cGy over 4½ weeks. In some clinical situations, the first-echelon nodes receive a much higher dose incidental to irradiation of the primary lesion. In the treatment portals used for cancers of the oropharynx, larynx, and hypopharynx, most of the high-risk neck nodes are encompassed by slight enlargement of the portals used to include the primary lesion. The decision to use elective lymph node irradiation depends on several factors:
  1. 1.

    Primary site and its relative density of capillary lymphatics

  2. 2.

    Risk of bilateral subclinical disease

  3. 3.

    Histologic grade and vascular space invasion

  4. 4.

    Depth of invasion and size of the primary lesion

  5. 5.

    Difficulty of neck examination

  6. 6.

    Relative morbidity for extending the lymph node coverage related to the risk of subclinical disease

  7. 7.

    Likelihood that the patient will return for frequent follow-up examinations

  8. 8.

    Suitability of the patient for a radical neck dissection should tumor appear in the neck



Neck Dissection Neck Node Radical Neck Dissection Elective Neck Dissection Oral Tongue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • J. T. Parsons
    • 1
  • R. R. Million
    • 1
  • W. M. Mendenhall
    • 1
  1. 1.Department of Radiation OncologyUniversity of Florida Health Science CenterGainesvilleUSA

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