The role of radiotherapy in the treatment of neck metastases from head and neck cancer

  • Nemetallah A. Ghossein
  • Pierre Bataini
Part of the Cancer Treatment and Research book series (CTAR, volume 22)


Anyone who attempts to familiarize himself with the voluminous literature on head and neck cancer will soon realize that there is a lack of uniformity in the treatment policies for patients with metastatic neck nodes secondary to squamous cell carcinoma. This is due mainly to the fact that the treatment methods are based on the philosophy and experience of the team leader involved in the management of these patients. Evidently, the management of neck nodes should depend primarily on the location and stage of the primary lesion, the extent of the neck disease, and the age and medical condition of the patient. In many centers, neck dissection for either clinically obvious or occult metastasis remains the accepted policy; reserving ratiation therapy for the surgical failures.


Oral Cancer Neck Dissection Radical Neck Dissection Capsular Invasion Pyriform Sinus 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ennuyer A, Bataini JP: Les tumeurs de l’Amygdale et de la region Velopalatine. Masson (Edit) Paris, 1956.Google Scholar
  2. 2.
    Leroux-Robert J, Ennuyer A, Calle R: Traitement des Cancers Hypopharynges et Laryngo- pharynges par FAssociation Chirurgie-Radiotherapie. Bull Cancer 37: 232–254, 1950.Google Scholar
  3. 3.
    Fletcher GH: Elective irradiation of subclinical disease in cancers of the head and neck. Cancer 29: 1450–1454, 1972.PubMedCrossRefGoogle Scholar
  4. 4.
    Fletcher GH, Jesse RH: Interaction of surgery and irradiation in head and neck cancers. Curr Probl Radiol 1: 2–27, 1971.Google Scholar
  5. 5.
    Million RR, Fletcher GM, Jesse RH: Evaluation of elective irradiation of the neck for squamous cell carcinoma of the nasopharynx, tonsillar fossa, and base of tongue. Radiology 80: 973–988, 1963.Google Scholar
  6. 6.
    Berger DS, Fletcher GH, Lindberg RD, Jesse RH: Elective irradiation of the neck lymphatics for squamous cell carcinomas of the nasopharynx and oropharynx. Amer J Roentgenol 111: 66–72, 1971.PubMedGoogle Scholar
  7. 7.
    Beahrs OH, Barber KW: The value of radical dissection of structures of the neck in the management of carcinomas of the lip, mouth, and larynx. Arch Surg 85: 49–72, 1952.Google Scholar
  8. 8.
    Strong EW: Preoperative radiation and radical neck dissection. Surg Clin North Am 49: 271–276, 1969.PubMedGoogle Scholar
  9. 9.
    Fletcher GH: Radiation therapy and surgery. In: Murphy GP (ed) International Advances in Surgical Oncology. Vol. 2. New York, Alan R, Liss Inc, 1979, pp 55–58.Google Scholar
  10. 10.
    Decroix Y, Ghossein NA: Experiences of the Curie Institut in treatment of cancer of the mobile tongue. II. Management of the neck nodes. Cancer 47: 503–508, 1981.PubMedCrossRefGoogle Scholar
  11. 11.
    Moyse P, Durand JC, Sadoul G: Le 4 Envahissement ganglionnaire dans les cancers de la partie mobile de la langue. Bull Cancer 59: 161–167, 1972.PubMedGoogle Scholar
  12. 12.
    Cachin Y, Eschwege F: Combinations of radiotherapy and surgery in the treatment of head and neck cancers. Cancer Treat Rev 2: 177–191, 1975.PubMedCrossRefGoogle Scholar
  13. 13.
    Cachin Y: Les modalites et la Valeur pronostique de l’envahissement ganglionnaire cervical dans les carcinomes des voies aerodigestives superieurs. Vie Med Can Fr 1: 48–00, 1972.Google Scholar
  14. 14.
    Richard J: Orientation recentes de la Chiriugie ganglionnaire du cou. In: Pinel J, Leroux- Robert J (eds) Adenopathies Cervicales Malignes. Masson, Paris, 1982, pp 94–105.Google Scholar
  15. 15.
    Cachin Y, Guerrier Y, Pinel J: Les adenopathies cervicales metastatique. Nuovo Arch Italian © di ORL 5: 207–220, 1977.Google Scholar
  16. 16.
    Ennuyer A, Bataini JP, Daudel R, Daudel P: A Propos de la Radiotherapie des Adenopathies Cervicales Secondaires aux Epitheliomas du Pharynx: Dose Ganglionnaire et Etalement. Bull Cancer 60: 1–14, 1973.PubMedGoogle Scholar
  17. 17.
    Bartelink H, Breur K, Hart G: Radiotherapy of lymph node metastases in patients with squamous cell carcinoma of the head and neck region. Int J Rad One Biol Phys 8: 983–989, 1982.CrossRefGoogle Scholar
  18. 18.
    Brugere J, Point D, Laurent M, Bataini P: Chirurgie Ganglionnaire cervicale post-radiother-apique –Indications et resultats. In: Pinel J, Leroux-Robert J (eds) Adenopathies Cervicales Malignes. Masson, Paris, 1982, pp 151–156.Google Scholar
  19. 19.
    International Union Against Cancer: TNM Classification of malignant tumors, Geneva, International Union Against Cancer, 1973.Google Scholar
  20. 20.
    International Union Against Cancer. TMN Atlas. Spiessel B, Scheibe O, Wagner G (eds) Springer-Verlag, New York, 1982.Google Scholar
  21. 21.
    Bataini JP, Bernier J, Brugere J, Jaulerry Ch, Brunin F, Picco CH: Approche Radiothera- pique des Adenopathies Cervicales secondaires aux Cancers Epidermiques du Larynx et du Pharynx. In: Pinel J, Leroux-Robert J (eds) Adenopathies Cervicales Maignes. Masson, Paris, 1982, pp 129–135.Google Scholar
  22. 22.
    Decroix Y, Ghossein NA: Experience of the Curie Institut in treatment of cancer of the mobile tongue. I. Treatment Policies and Results. Cancer 47: 496–502, 1981.PubMedCrossRefGoogle Scholar
  23. 23.
    Lee JG, Krause CJ: Radical neck dissection: Elective, therapeutic, and secondary. Arch Otolaryngol 101: 656–659, 1975.PubMedGoogle Scholar
  24. 24.
    Nahum AM, Bone RC, Davidson TM: The case for elective prophylactive neck dissection. J Amer Acad Ophth and Otol 82: 603–612, 1976.Google Scholar
  25. 25.
    Spiro RH, Strong EW: Epidermoid carcinoma of the mobile tongue. Treatment by partial glossectomy alone. Am J Surg 122: 707–710, 1971.PubMedCrossRefGoogle Scholar
  26. 26.
    Fletcher GH: Textbook of Radiotherapy. Lea and Febiger, Philadelphia, 1980, pp 180–219.Google Scholar
  27. 27.
    Ghossein NA, Bataini JP, Ennuyer A, Stacey P, Krishnawamy V: Local control and site of failure in radically irradiated supraglottic laryngeal cancer. Radiology 112 (1): 187–192, 1974.PubMedGoogle Scholar
  28. 28.
    Bataini P, Brugere J, Bernier J, Jaulerry CH, Picot C, Ghossein NA: Results of radical radiotherapeutic treatment of carcinoma of the pyriform sinus: Experience of the Institut Curie. Int J Radiation One Biol Phys 8: 1277–1286, 1982.CrossRefGoogle Scholar
  29. 29.
    Jesse RM, Barkley MT Jr., Lindberg RD, Fletcher GH: Cancer of the oral cavity-is elective neck dissection beneficial? Am J Surg 120: 505–508, 1970.PubMedCrossRefGoogle Scholar
  30. 30.
    Fitspatrick PJ, Tepperman BS: Cervical Lymph node metastases: The place of radiotherapy. In: Kagan AR, Miles J (eds) Head and Neck Oncology –Controversies in Cancer Treatment. G.K. Hall, Publishers pp 233–245, 1981.Google Scholar
  31. 31.
    Fayos JV, Lampe I: The therapeutic problem of metastatic neck adenopathy. Am J Radiol 114: 65–75, 1972.Google Scholar
  32. 32.
    Million RR: Elective neck irradiation for treatment of squamous carcinoma of the oral tongue and floor of mouth. Cancer 34: 149–155, 1974.PubMedCrossRefGoogle Scholar
  33. 33.
    Meor RT, Flatcher GH, Lindberg RD: Anatomical coverage in elective irradiation of the neck for squamous cell carcinoma of the oral tongue. Int J Rad One Biol Phys 8: 1881–1885, 1982.CrossRefGoogle Scholar
  34. 34.
    Lindberg RD: Distribution of cervical lymph node metastasis from squamous cell carcinoma of the upper respiratory and digestive tract. Cancer 29: 1446–1449, 1972.PubMedCrossRefGoogle Scholar
  35. 35.
    Fletcher GH: Textbook of Radiotherapy. Lea and Febiger, Philadelphia, 1980, pp 249–271.Google Scholar
  36. 36.
    Bataini JP, Ennuyer A, Poncet P, Ghossein NA: Treatment of supreglottic cancer by radical high dose radiotherapy. Cancer 33: 1253–1262, 1974.PubMedCrossRefGoogle Scholar
  37. 37.
    Regoud CEA: Les adenopathies consecutives aux cancers des levres, de la bouche; leurs indications therapeutique; leur traitement. Radiophysiologie et Radiotherapie 1, 1928.Google Scholar
  38. 38.
    Quick D: Radium in the treatment of metastatic epidermoid carcinoma of the cervical lymph nodes. Amer J Radiol 33: 677–681, 1935.Google Scholar
  39. 39.
    Duffy SS: Treatment of cervical nodes in intra oral cancer. Surg Gynec Obst 664–671, 1940.Google Scholar
  40. 40.
    Martin HE, Sugarbaker E: Cancer of the tonsil. Am J Surg 52: 158–196, 1941.CrossRefGoogle Scholar
  41. 41.
    Brugere J, Bataini P, Point D, Jaulerry C: L’envalissment ganglionnaire cervical des epitheliomas du Naso-pharynx. Compte Rendue 74th Congres francais d’Orl, Paris, 1977, Arnette Ed. (Paris) pp 269–275.Google Scholar
  42. 42.
    Wizenberg MJ, Bloedorn FG, Weiner S, Garcia JR: Radiation therapy in the management of lymph node metastasis from head and neck cancers. Am J Radiol 114: 76–82, 1972.Google Scholar
  43. 43.
    Schneider JJ, Fletcher GH, Barkley MT: Control by irradiation alone of non fixed clinically positive lymph nodes from squamous cell carcinoma of the oral cavity, oropharynx, supra-glottic larynx, and hypopharynx. Am J Radiol 123: 42–48, 1975.Google Scholar
  44. 44.
    Decroix Y: Personal communication.Google Scholar
  45. 45.
    Berger PS, Bataini JP: Radiation-induced cranial nerve palsy. Cancer 40: 152–155, 1977.PubMedCrossRefGoogle Scholar
  46. 46.
    Bataini JP: Meeting Groupe European Radiotherapie, Helsinki, 1979: Results of Radiotherapy of 1000 patients with pharynx tumors.Google Scholar
  47. 47.
    Sobel S, Rubin P, Keller B, Poulter C: Tumor persistence as a predictor of outcome after radiation therapy of head and neck cancers. Int J Rad One Biol Phys 1: 873–880, 1976.CrossRefGoogle Scholar
  48. 48.
    Laramore GE, Griffin TW, Tesh DW, Wong HH, Parker RG: Phase 1 pilot study of fast neutron teletherapy for advanced carcinomas of the head and neck. Cancer 25: 192–199, 1982.Google Scholar
  49. 49.
    Hong WK, Bromer R: Current concepts: chemotherapy in head and neck cancer. New Engl J Med 308: 75–79, 1983.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers, Boston 1984

Authors and Affiliations

  • Nemetallah A. Ghossein
  • Pierre Bataini

There are no affiliations available

Personalised recommendations