After a brief review of the literature, the results of the treatment by radiation therapy in 218 patients with tonsillar region carcinoma are reported. The patients were treated at the Turin University Radiotherapy Department (131 cases) and at the Radiotherapy Department of the Ospedale Maggiore, Novara (87 cases) from 1976 through 1984. The series included 29 T1, 88 T2, 64 T3 and 37 T4; 86 patients (40%) were N0. Only 49 patients were stages I and II (1/4 of the total). The local control (T) rate at the end of therapy was 63.5% for the overall series (139/218) ranging from 100% in T1, 72.6% T2, 54.6% T3 to 30% T4; the regional control (N) for patients with cervical lymphadenopathy was 66% (88/132). The overall 5-year survival was 38%; the 5-year disease-free survival was 35%. The 5-year survival according to T-stage was 52% for limited cases (T1-T2) in comparison to 22% for advanced ones (T3-T4). The 5-year survival for N0 stage was 55%; when neck nodes were present (N # 0) the survival was 29% after 5 years. Complications included 6 cases of trismus and 2 osteonecroses of the mandible. Second primary malignant diseases were seen in 17 cases (7.8%). The most common cause of death was failure in primary tumour control (80% of cases). In this series the results of radiotherapy of early stage tonsillar carcinomas are quite good; patients with large tumour masses fare less satisfactorily. Better results should be obtained in the future by identifying prognostic factors, monitoring potential causes of treatment failure and optimizing the radiotherapeutic treatment plan and technique.
[Results of radiotherapy in the treatment of 218 carcinomas of the tonsillar area]
RAGONA, Riccardo;
1987-01-01
Abstract
After a brief review of the literature, the results of the treatment by radiation therapy in 218 patients with tonsillar region carcinoma are reported. The patients were treated at the Turin University Radiotherapy Department (131 cases) and at the Radiotherapy Department of the Ospedale Maggiore, Novara (87 cases) from 1976 through 1984. The series included 29 T1, 88 T2, 64 T3 and 37 T4; 86 patients (40%) were N0. Only 49 patients were stages I and II (1/4 of the total). The local control (T) rate at the end of therapy was 63.5% for the overall series (139/218) ranging from 100% in T1, 72.6% T2, 54.6% T3 to 30% T4; the regional control (N) for patients with cervical lymphadenopathy was 66% (88/132). The overall 5-year survival was 38%; the 5-year disease-free survival was 35%. The 5-year survival according to T-stage was 52% for limited cases (T1-T2) in comparison to 22% for advanced ones (T3-T4). The 5-year survival for N0 stage was 55%; when neck nodes were present (N # 0) the survival was 29% after 5 years. Complications included 6 cases of trismus and 2 osteonecroses of the mandible. Second primary malignant diseases were seen in 17 cases (7.8%). The most common cause of death was failure in primary tumour control (80% of cases). In this series the results of radiotherapy of early stage tonsillar carcinomas are quite good; patients with large tumour masses fare less satisfactorily. Better results should be obtained in the future by identifying prognostic factors, monitoring potential causes of treatment failure and optimizing the radiotherapeutic treatment plan and technique.
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