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Carcinoma of the tonsillar region: A multivariate analysis of 243 patients treated with radical radiotherapy
Author(s) -
Lee W. Robert,
Mendenhall William M.,
Parsons James T.,
Million Rodney R.,
Cassisi Nicholas J.,
Stringer Scott P.
Publication year - 1993
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.2880150402
Subject(s) - radiation therapy , medicine , stage (stratigraphy) , multivariate analysis , t stage , basal cell , carcinoma , surgery , complication , overall survival , paleontology , biology
Between October 1964 and June 1990, 243 patients with squamous cell carcinoma of the tonsillar region were treated with continuous‐course radical radiotherapy at the University of Florida. All patients had a minimum 2‐year follow‐up. Patients were staged according to the AJCC system; stage IV was stratified into two subsets: favorable, IVA (T1‐T3 or N2A‐N3A); and unfavorable, IVB (T4 or N3B). The initial and ultimate local control rates (including surgical salvage) according to T stage were as follows: T1, 87% and 100%, T2, 79% and 92%; T3, 71% and 76%; and T4, 44% and 48%. Multivariate analysis demonstrated that anterior extension of the primary tumor ( p = .0001) and T stage ( p = .014) were the most significant parameters affecting local control after radiotherapy. For T4 lesions, twice‐daily irradiation significantly improved local control ( p = .04). The 5‐year absolute and cause‐specific survival rates as a function of modified AJCC stage were as follows: 1, 37% and 100%; 11, 55% and 90%; 111, 55% and 85%; IVA, 35% and 60%; and IVB, 23% and 38%. The probability of a severe complication was 3% for the entire group of patients.