Treatment Results of Hypopharyngeal Carcinoma / 대한치료방사선과학회지

A retrospective review of fifty patients with carcinoma of hypopharynx treated with RT+/-surgery was studied for eleven-year period from 1974 to 1984. Of the 50 patients, 46 were pyriform sinus in origin, 4 were posterior pharyngeal wall. Eighty-eight percent of patients were locoregionally advance (stage III, IV) and 78% of patients presented cervical lymphadenopathy. 5-year disease-free survival rate of the pyriform sinus ca. was 25.4% in RT alone group, 80% in combined modality group and 30.6% in overall. Local control rate with RT alone in early stage (II) was excellent (100%), however combined modality appears to be better for local control (80%) in advanced stage (III, IV) as compared with that of RT alone group (32%). On basis of this study, RT alone is effective in terms of local control and functional preservation in treatment of early stage of pyriform sinus ca. while surgery can be reserved for salvage purpose when RT fails and combined modality is recommended in patients with locally advanced stage for better local control and survival.

Radiation Therapy Results of the Non-Hodgkin's Lymphoma of the Sinonasal cavity / 대한치료방사선과학회지

From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation. 13 patients were stage IE and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were 25%, 28% for IE and 0% for IIE. Total tumor dose varied from 40 to 68 Gy. 100% complete response with a total tumor dose of more than 55 Gy and 73% complete response with less than 55 Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was 50% as compared with 14% for T3 and T4. Failure rate by stage was 33% (2/6) for T1 and T2, 86% (6/7) for T3 and T4, and 100% (2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tumor dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.

Clinical and Therapeutic Aspects of Squamous Cell Carcinoma of Oral Tongue / 대한치료방사선과학회지

Fourty nine patients with squamous cell carcinoma of oral tongue were reviewed retrospectively for the evaluation of clinical manifestation and for the comparison between therapeutic modalites. The gross shape of the tumor was infiltrative in 22, ulcerative in 12, and ulceroinfiltrative type in 10 patients. Direct extension of the tumor was most commonly to the floor of the mouth. The incidence of nodal metastasis generally increased with tumor stage. 55% of the patients showed neck nodal metastasis at the time of diagnosis. Ipsilateral subdigastric node were most commonly involved, followed by submandibular nodes. The 5-year survival rate of patients treated with surgery and radiotherapy was 58.7% in contrast to 21.6% in radiation alone group. Overall 5-year survival rate was 31%. In radiation alone group, half of the patients in stage I, II were locally controlled. But the local control in stage III, IV was much inferior to early lesions. Especially, of 4 patients combined with implantation tecnhnique, 3 were completely controlled. 5-year survival rate of these implanted patients was 50%, 49.4% of patients treated over 7,000 cGy survived 5 years. This was significant in contrast to 6.4% of the group treated below 7,000 cGy. The most common sites of failures were primary sites. In early lesions primary radiotherapy with implantation would be an appropriate treatment in cancer of oral tongue, operation reserved for radiation failure. Operation and adjuvant radiotherapy is recommended in cases of advanced disease.