Elective Irradiation of the Neck in Patients With Primary Carcinoma of the Head and Neck

The lack of a randomized prospective study of the efficacy of elective irradiation of the cervical lymph nodes in patients with primary carcinoma of the head and neck forces us to carefully study retrospective studies for the contemporary evaluation of this therapeutic concept. In spite of this shortcoming, it has become increasingly obvious that the contention that irradiation is unable to control cervical lymph node metastases is no longer tenable. Furthermore, increasing evidence from several centers indicates that lethal irradiation of occult, ie, microscopic, foci of carcinoma of epithelial origin which is deposited in cervical adenopathy is highly effective. In order to develop the argument for elective neck irradiation, it is pertinent to briefly review some of the evidence in favor of the ability of radiation therapy alone to control more obvious cervical metastatic disease. A previous communication²⁰analyzed the results of radiation therapy alone in 69 patients with