Radiation therapy for carcinoma of the hypopharynx with special reference to nodal control

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Abstract
From October 1977 through December 1983, 61 patients with carcinoma of the hypopharynx were treated with radiation therapy (RT) and surgery or with RT alone. Five-year survival rates by N-stage, according to the TNM classification by UICC (1978), were 52% for N0 cases, 23% for N1, and 17% for N2-3 (N1 vs. N2-3, not significant). For N1-3 cases, corresponding figures by level of cervical nodal involvement by UICC (1978) were 29% for level 3 cases, 15% for level 2, and 8% for level 4 (level 3 vs. level 4, p less than 0.04). Therefore, the level of cervical nodal involvement was a more useful prognosticator for patients with nodal metastasis than the N-stage. Effective nodal control for patients with clinically positive nodes (N1-3) was obtained with a combination of neck node dissection and RT of 50 Gy or more. For N0 cases, elective RT of 50 Gy or more, encompassing an adequate field, was required.