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Analysis of failures after definitive irradiation for epidermoid carcinoma of the nasopharynx
Author(s) -
Bedwinek John M.,
Perez Carlos A.,
Keys David J.
Publication year - 1980
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19800601)45:11<2725::aid-cncr2820451105>3.0.co;2-1
Subject(s) - medicine , epidermoid carcinoma , incidence (geometry) , stage (stratigraphy) , radiation therapy , carcinoma , primary tumor , chemotherapy , t stage , surgery , oncology , cancer , gastroenterology , metastasis , biology , paleontology , physics , optics
From 1955 to 1976, 111 patients were treated with definitive radiotherapy for epidermoid carcinoma of the nasopharynx. There was a definite correlation between recurrence at the primary site and T‐stage; 9.5% of T 1–2 patients, 38.1% of T 3 patients and 54.1% of T 4 patients had local recurrences. Similarly, failure in the neck correlated with N‐stage, being negligible for N 0 and N 1 but 28.6% for N 2 and 36.1% for N 3 . The incidence of distant metastases had no correlation with T‐stage but correlated very closely with N‐stage. The patients were grouped into four T and N categories, T 1–2 N 0–1 , T 1–2 N 2–3 , T 3–4 N 0–1 , and T 3–4 N 2–3 . The five year relapse‐free survival for the T 1–2 N 0–1 category was 69% but was only about 20% for each of the other three categories. The major cause of poor survival for the T 3–4 N 0–1 category was recurrence at the primary site, whereas for the T 1–2 N 2–3 and T 3–4 N 2‐3 categories, it was the high incidence of distant metastases, approximately 50%. Recommendations are to increase dose at the primary site for T 3–4 N 0–1 patients and to institute clinical trials testing adjuvant chemotherapy for patients with neck stages N2 and N3.