Definitive radiotherapy for T1 and T2 squamous cell carcinoma of the tonsil.
BACKGROUND
To assess whether survival or local control of early squamous cell carcinoma of the tonsil has been compromised by a moderate-dose approach.


METHODS
Between 1970 and 1989, 185 patients with SCCa of the tonsil were seen at our institution. Fifty-three patients with T1 (30) and T2 (23) lesions treated with definitive radiotherapy were reviewed. Median follow-up was 60 months. The effects of total dose and site of the primary on survival and local regional control were analyzed.


RESULTS
Three-year determinate survival was 77%. Mean total dose was 63.1 Gy. Site of the primary significantly affected survival (86% for fossa, 54% for pillars, p < 0.025). Local control at 2 years was 81% and was independent of dose > or = 63 Gy or site of the primary. Grade 4 complications defined by the RTOG/EORTC Acute Morbidity criteria occurred in three patients.


CONCLUSIONS
Tumor doses on the order of 63 Gy or less result in excellent local control and survival rates for T1 and T2 carcinomas of the tonsil. Local control rates are better for fossa lesions than for pillar lesions.
Moose
B D
BD
Department of Therapeutic Radiology and Oncology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Kelly
M D
MD
Levine
P A
PA
Constable
W C
WC
Cantrell
R W
RW
Larner
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016001:Confidence Intervals; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011829:Radiation Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D014067:Tonsillar Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D017211:Treatment Failure