TONSILLAR CARCINOMA - ANALYSIS OF TREATMENT RESULTS

Objective: Early stage squamous cell carcinoma of the tonsil is amenab le to treatment by either surgery or radiation therapy as a single mod ality, with comparable rates of local control. Unfortunately, manifest ation of the disease at an early stage is infrequent, and surgery or r adiation alone is less successful in controlling advanced disease. Thi s study was conducted to elucidate the optimal treatment plan for adva nced stages of tonsillar carcinoma and to identify significant risk fa ctors for development of recurrence or failure of local control. Metho d: We reviewed the UCLA experience with treatment of all stages of ton sillar carcinoma between 1970 and 1990. Results: Actuarial local contr ol rates were 70% for T1, 72% for T2, 50% for T3, and 0% for T4 at 5-y ear follow-up. Local control and overall survival rates were compared according to the type of treatment rendered for each stage. Conclusion s: From our analysis we conclude that aggressive combination therapy w ith surgery and radiation yields significantly higher local control ra tes for stages 3 and 4 tonsillar carcinomas. The advantages and disadv antages of preoperative versus postoperative radiation therapy are dis cussed.