ABSTRACT
A series of 159 patients with carcinoma of the tonsil was treated by radiotherapy from Jan. 1970 to Dec. 1980. The overall 5, 10 and 15 year survival rates were 45.3% (72/159), 30.8% (32/104) and 34.8% (8/23). The 5 year survival rate was 62.5% (10/16), 68.9% (31/45), 39.0% (16/41) and 22.8% (12/57) for stages I, II, III and IV. There was no significance difference in the 5 year survival rates between undifferentiated (38/86, 44.2%) and squamous cell carcinomas (34/70, 48.6%). The majority of these patients received a dose of 50-70 Gy/6-8 weeks. Clinical stage and metastatic lymph node's size are the main factors influencing prognosis. The chief causes of failure: recurrence and distant metastasis totaled 73.2%, of which 11.3% metastasized into the abdomen. The authors believe that a large anterior tangential portal with a high upper margin is necessary to include the big metastasis in the subgastric lymph nodes on the homolateral neck region.
Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Carcinoma/radiotherapy , Tonsillar Neoplasms/radiotherapy , Adolescent , Adult , Aged , Carcinoma/mortality , Carcinoma, Squamous Cell/mortality , Cobalt Radioisotopes/therapeutic use , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Prognosis , Tonsillar Neoplasms/mortalityABSTRACT
One thousand one hundred and thirty-six patients surviving for more than five years after radiotherapy were studied. The important prognostic factors are: lesion less than 5 cm in length, lesion located in the upper-third segment and lesion that is radiosensitive. The radiation dose given to long term survivors varies greatly, i.e., 2700 to 9300 rad. Yet, for the sensitive type of lesion, doses lower than 5000 rad could also effect a cure. The delivery of an optimum dose determined by serial examinations during radiotherapy could improve the result of treatment. For local recurrent lesions, the value of a second course of radiation is extremely limited and surgery is the only means to offer a cure. For metastasis in the lymph nodes, radiation offers some hope of cure, although the long term outcome may not be satisfactory. For second primary cancer of the esophagus, aggressive radiation still gives encouraging results.
