RADIATION-THERAPY FOR SQUAMOUS-CELL CARCINOMA OF THE TONSIL

Objective: To characterize the patient population referred for radiati on therapy for tonsillar cancer and to assess the effectiveness of use , of only radiation therapy in this population. Design: We retrospecti vely reviewed the medical records of 21. patients referred to the Mayo Clinic in Rochester, Minnesota, from 1970 through 1988 for radiation therapy for squamous cell carcinoma of the tonsillar region. Material and Methods: The median age of the 21 study patients was 65 years (ran ge, 45 to 92), and the mate:female ratio was 12:9. In all patients, fo llow-up continued until death or for 2.25 to 16.25 years. Of the 21 pa tients, 17 had tumors that were either surgically unresectable or medi cally inoperable, and 20 had clinical stage m or IV disease. The media n total dose or irradiation was 55 Gy. Results: Local control of the t onsillar cancer was as follows: T2, four of five patients; T3, seven o f seven; and T4, five of nine. Thus, the local control rate was 76%. N o associations were discovered among local control, total dose of radi ation therapy, dose per fraction, overall duration of treatment, age, sex, or reason for referral for radiation therapy. Control of metastat ic cervical adenopathy was as follows: clinical stage N1, seven of sev en patients; N2, six of seven; and N3, one of one. (Six study patients had no nodal involvement.) The estimated 5-year cause-specific surviv al and overall survival rates were 77% and 31%, respectively. Conclusi on: This study substantiates the effectiveness of radiation therapy in patients with squamous cell carcinoma of the tonsil.