title: Limitations of radiotherapy in the definitive treatment of squamous carcinoma of the tonsillar fossa.
abstract: Between 1970 and 1990, 104 patients with squamous cell carcinoma (SCC) of the tonsil were treated. The median age was 58 years and 80% of patients were males. Distribution among clinical stages was: stage I, 19 patients; stage II, 12 patients; stage III, 23 patients; and stage IV, 48 patients. More than 70% of patients had initial radiotherapy as definitive treatment irrespective of stage, reflecting the treatment philosophy over much of this period. The overall survival rate was 26% at 5 years, with survival being significantly affected by T stage, clinical stage and age. Clinical node status did not significantly affect survival rates. Good local control of T1N0 cancers was achieved with radiotherapy alone, but patients with more advanced cancers did poorly. We have now moved away from a non-selective policy and use initial surgery combined with postoperative radiotherapy in most patients, reserving radiotherapy alone for mainly early tonsil cancers.
authors.affiliation: Head and Neck Service, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: C J
authors.initials: CJ
authors.lastname: O'Brien
authors.forename: G K
authors.initials: GK
authors.lastname: Castle
authors.forename: G N
authors.initials: GN
authors.lastname: Stevens
authors.forename: G
authors.initials: G
authors.lastname: MacHalliday
authors.forename: J K
authors.initials: JK
authors.lastname: Donovan
authors.forename: K K
authors.initials: KK
authors.lastname: Lee
authors.forename: N A
authors.initials: NA
authors.lastname: Packham
authors.forename: M J
authors.initials: MJ
authors.lastname: Peat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D014067:Tonsillar Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery