EFFECTS OF POSTOPERATIVE EXTERNAL-BEAM IRRADIATION AFTER CAROTID-ARTERY STRIPPING OF NODAL METASTASIS

Purpose: The objective of this study was to determine the effects of p ostoperative external beam irradiation (PEBI) on patients after stripp ing the carotid vessel of nodal metastasis. Patients and Methods: Of 2 45 patients who underwent radical neck dissection for cancer of the up per aerodigestive tract between 1981 and 1995, 13 patients with nodal metastasis adherent to the carotid artery (NMCA) received a full cours e of PEBI after the tumor was peeled off the carotid vessel. Patterns of treatment failure, survival, and serious morbidity were evaluated. Results: At the time of last follow-up (range, 3 to 125 months), fewer than half of the patients (46%) were free of disease, and two patient s (15%) had developed distant metastases, The estimated 2-year surviva l rate was 23%, There were no intraoperative, postoperative, or post-r adiation therapy complications. Conclusion: PEBI after carotid artery stripping of tumor can achieve locoregional disease control in select patients without an increased risk of vessel rupture. However, if the prognosis for patients with NMCA is to improve, other effective manage ment strategies need to be investigated.