Carcinoma of the mobile tongue: incidence of cervical metastases in early lesions related to method of primary treatment.

One hundred thirty-eight patients receiving initial treatment for squamous cell carcinoma of the mobile tongue from 1960 to 1978 were reviewed to determine the frequency of cervical metastasis in early carcinoma (T1N0 and T2N0). Occult cervical node metastasis in an elective neck dissection or subsequent neck recurrence in an initially negative neck was found in 14.5% (9/62) of patients staged T1N0 and 30.6% (11/36) of patients staged T2N0. Refinement of the staging system demonstrated that 9.7% (3/31) of patients with a primary lesion less than or equal to 1.0 cm and a clinically negative neck (T1aN0) subsequently developed a cervical metastasis. Patients with primary lesions greater than 1.0 cm but less than or equal to 2.0 cm (T1bN0) had twice the risk of occult cervical metastasis (19.4% or 6/31). The crude 5-year survivals in Stage I for radium alone, partial glossectomy, and partial glossectomy with neck dissection were 64%, 58% and 75% respectively and in Stage II were 31%, 66% and 71% respectively. Local-regional failure is the principal mechanism of failure in patients treated locally particularly in Stage II.

Small cell carcinoma of the lung: results of combination chemotherapy and radiation therapy.

A retrospective study of 244 patients treated for small cell carcinoma of the lung from Jan 1, 1971 to Dec 31, 1976 revealed that 34% of patients, with local-regional disease who received radiation alone survived one year (median survival, seven months), and 53% with local-regional disease survived one year (median survival, 12 months) when treated with combination chemotherapy and radiation. The one-year survival for patients presenting with metastatic disease was 14.5% (median survival, five months) when treated with radiation alone and 50% (median survival, 11 months) when treated with combination chemotherapy and radiation. Although combination chemotherapy and radiation will prlong the disease-free interval in patients with small cell carcinoma of the lung, more than 90% will develop evidence of progressive disease within two years.

A simple method of protecting the eye from scattered radiations during mantle-field therapy.

The intensity and quality of scattered radiations incident on the eye during mantle-field therapy were measured for 4-MV x rays. Beam-shaping appliances were found to introduce considerable soft scatter. Eye shields reduce radiation exposure from the anterior field approximately threefold.

Recurrence patterns and survival after combined radical mastectomy and postoperative irradiation: a retrospective analysis.

Recurrence patterns were analyzed in 323 patients treated by radical mastectomy, 219 of whom received postoperative irradiation. Thirty-five patients with inner quadrant lesions and negative axillary nodes received postoperative regional node irradiation; 33 of these 35 patients are alive without recurrence from 2 to 22 years later. Six of 219 patients receiving postoperative regional lymph node irradiation developed recurrence in the treated area. In patients with positive axillary nodes, 27% of all recurrence developed initially in the chest wall region, and an additional 10% of patients developed distant metastases in addition to chest wall recurrence. The high incidence of chest wall recurrence in patients with four or more positive nodes, and in patients with two or three positive nodes and primary lesions over 3 cm in diameter who did not receive chest wall irradiation, suggests that the maximal benefit from postoperative irradiation would not be realized in prospective, randomized studies without the use of chest wall irradiation postoperatively in these categories of patients.