OROPHARYNGEAL CARCINOMA TREATED WITH RADIOTHERAPY - A 30-YEAR EXPERIENCE

Purpose: This study was done to determine the outcome in patients with oropharyngeal carcinoma treated at the University of Florida with rad iotherapy alone to the primary site, for comparison with reported resu lts of other types of treatment. Methods and Materials: Of a consecuti ve cohort of 785 patients with biopsy-proven, previously untreated, in vasive squamous cell carcinoma of the oropharynx, this report is based on the 490 patients who had continuous-course irradiation with curati ve intent at the University of Florida between October 1964 and Januar y 1991, All patients had a minimum 2-year follow-up, Forty-eight perce nt had Stage T3 or T4 disease, and 64% had clinically apparent neck no de metastases, The median radiation dose was 68 Gy for once-a-day trea tment and 76.8 Gy for twice-a-day treatment, Patients with advanced ne ck node disease had planned neck dissection(s) after radiotherapy. Res ults: The overall local control rate after radiotherapy alone was 73%, The ultimate local control rate (including surgical salvage) was 78%. At 5 years, the probability of control of neck disease was 85%; contr ol above the clavicles, 67%; absolute survival, 44%; cause-specific su rvival, 77%; distant metastasis (as the first or only site of failure) , 11%, Thirteen patients (2.6%) experienced severe treatment complicat ions. Conclusion: Radiotherapy results in tumor control and survival r ates comparable with rates achieved with combined irradiation and surg ery, with less morbidity.