Squamous cell carcinoma of the oropharynx: an analysis of 213 consecutive patients scheduled for primary radiotherapy.

Radiotherapy was administered to 213 consecutively treated patients with oropharyngeal squamous cell carcinoma. The classification (Union Internationale Contre le Cancer, 1982) showed primary tumors (T1, 13%; T2, 51%; T3, 34%; T4, 2%) and regional lymph nodes (N0, 38%; N1, 38%; N2, 4%; N3, 20%). The 10-year actuarial value for local control was 48%; for regional control, it was 66%. Distant failure occurred in 20 patients. The 10-year actuarially corrected survival rate was 40% (stage I, 57%; stage II, 51%; stage III, 43%; stage VI, 21%). Locoregional tumor control was significantly influenced by irradiation parameters (total dose and treatment time), tumor volume, sex, and hemoglobin value. It is concluded that local control of the tumor while still in the T position is the parameter most crucial to success. This end point is currently being aimed at evaluating primary surgery and testing a radiation technique with larger total doses and shrinking fields and a new radiosensitizer, while at the same time investigating the influence of hemoglobin concentration.