neck_nodes.jpg (4839 bytes)
Recommended radiation dose from Perez (Text 1998)
Node Size Dose at 200cGy/fx Dose at 180cGy/fx
1cm or less 60Gy 65Gy
1.5 - 2.0 cm 65Gy 70Gy
2.5 - 3.0 cm 70Gy 75Gy
3.5 - 6.0 cm 75Gy 80Gy

Relapse Rate by Treatment and Node Stage (Fletcher Am J Surg 1972;124:462)
Treatment N1 N2a N2b N3a N3b
XRT 15% 27% 27% 38% 34%
Surgery 11% 8% 23% 42% 41%
Surg + XRT 0% 0% 0% 23% 25%

Local Control by Stage and Therapy (UF Data in Perez)
Stage XRT XRT + Surgery
N1 86% 93%
N2a 79% 68%
N2b 70% 91%
N3a 33% 69%

Local Control by Radiation and Node Size (Mendenhall IJROBP 1984;10:639)
Node Size Local Control
< 1 cm 100%
1cm 82%
1..5 to 2cm 83%
2.5 to 3cm 60%
3.5 to 6 cm 63%
7cm or larger 0%