Records of 295 patients treated for carcinoma of the lung have been reviewed. 64 patients (21.7%) had a supraclavicular involvement at initial presentation, local control was achieved in that region in 26 out of 27 (96%) patients who received a minimum dose of 5,000 rads in 25 treatments. "Local control" applies to complete disappearance of disease in that area with no subsequent recurrence at any time or until death of the patient. One patienthad persistent disease despite a dose of 7,000 rads in 35 treatments. Elective supraclavicular irradiation was given to 79 patients, one of whom subsequently developed clinically detectable disease there. One hundred fifty-three patients did not receive elective supraclavicular irradiation, and 2 1 (14%) subsequently developed supraclavicular disease, a statistically significant difference. Patients considered at higher risk for supraclavicular metastasis were selected for elective supraclavicular irradiation. Therefore, the markedly lower rate of involvement in the treated patients can be attributed to the irradiation given that group. Overall, supraclavicular nodes were present in 24.8%, 30.2%, 34.1%, and 31.5% of patients with squamous cell carcinoma, adenocarcinoma, and undifferentiated small and large cell carcinoma, respectively. Seventy-six of 85 patients (89.4%) with supraclavicular involvement had hilar and/or mediastinal involvement at initial presentation. No significant difference in survival was observed between patients receiving supraclavicular, irradiation and those not receiving treatment to that area. Of 64 patients with initial supraclavicular involvement, there were 14, 9, and 5 survivors at 12, 18, and 24 months, respectively, with four patients surviving beyond 36 months, Cancer 41:124-129,1978.
HE SUPRACLAVICULAR LYMPH NODES LIE AT
T the base of the neck, in communication with collecting lymphatic trunks draining the head and neck, axilla and mediastinum. Thus, they are sites of potential metastasis from malignancies arising in various organs, including the lung. In 122 patients with clinically evident supraclavicular node involvement, lung cancer was the most frequent primary site in the series of Viacava and Pack.' Jakobson found supraclavicular node involvement in 16% .of lung can-From the * Tufts-