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1. Eight of 469 patients (1.7 per cent) developed new nodal disease in an electively irradiated area.2. Nineteen of 185 patients (10.2 per cent) with partial neck irradiation developed new nodal disease in a marginally irradiated or unirradiated area.3. A tissue dose of 4,500 to 5,000 rads tumor dose in 5 weeks is proposed for the irradiation of elective areas. This dose produces no complications or even minor sequelae.4. Whole neck irradiation is indicated for squamous cell carcinomas of the nasopharynx, tonsillar fossa, base of tongue, and N2 and N3 of the palatine arch.

The recent epidemic of thyroid carcinoma in the Chicago area results from irradiation to the neck area in infancy and childhood. Fortunately, x-ray therapy for shrinking tonsils, adenoids, and thymus glands and treating acne and other benign conditions has been discontinued for at least 15 years, but the late effects of such therapy are being reported with increasing frequency. The study by Refetoff and his co-workers in this issue of the Journal describing the high incidence of thyroid carcinoma appearing years after neck irradiation (average of 25 years) confirms their earlier report1 and the findings of others that external irradiation . . .

lesion. An experimental autoallergic sialadenitis (EAS) of the rat submandibular gland was developed to serve as the standard lesion. Consistently mild or severe lesions of EAS were induced in male Lewis rats when they were immunized with allogeneic submandibular glands from sexually immature or mature female donors, respectively. Neck irradiation alone 7-56 days prior to sacrifice induced only occasional inflammatory lesions in the submandibular glands. The weights of the submandibular glands were seen to decrease progressively while the body weights continued to rise. Neck irradiation 7-56 days prior to sacrifice of animals immunized 7-21 days prior to sacrifice to induce mild or severe EAS did not significantly accelerate development of the lesion nor was the intensity of inflammatory lesions significantly modified. In animals with mild or severe EAS which were neck irradiated, the weights of the submandibular glands were found to decrease while the body weight remained relatively unchanged. Thus, the influences of neck irradiation (1000 R) (primarily a progressive submandibular weight decrease) neither significantly altered nor was altered by the development of the experimental autoallergic lesion of the submandibular gland.