OBJECTIVE: To compare the efficacy and treatment outcomes in patients with tonsillar fossa cancer using surgery or radiation as a single modality therapy. METHODS: From 1971 to 1991 239 patients with oral pharyngeal cancer were treated at Roswell Park Cancer Institute. Of these patients 90 had tonsillar carcinoma. Seventy-six of these patients received either surgery (SA) (n = 56) or radiation therapy (RA) (n = 20) as single-modality therapy and are the subject of this review. All patients in the radiation arm of this review were surgical candidates who declined primary surgical therapy. RESULTS: Sixty-three percent of the SA and 80% of the RA treatment groups presented with either stage III or stage IV disease (P < or = .05). Forty-seven percent of the SA group and 52% of the RA patients had clinically positive regional disease at initial presentation. There was a predictable pattern of nodal presentation, with level II the most frequently involved region. The rate of occult metastasis was 27% and was evenly distributed between T1 and T4 disease. The overall local control rate in the SA group was 75%, compared with 60% in the RA group (P value was not significant). The disease-specific survival (all stages) was 61% in the SA group and 37% in the RA group (P < or = .05). The disease-free survival for stage III and stage IV disease in the SA group was 47% and in the RA group 27% (P < or = .05). Survival measured against clinical response to radiation therapy, in complete responders (all stages) was 83%; by contrast there were no survivors past 24 months in the partial response group (P < or = .001). CONCLUSION: The results from this study suggest that for early disease (stage I/II), surgery or radiation therapy as single-modality treatment is equally effective. For advanced disease radiation therapy is inferior to surgery as a single-modality treatment, as measured by ultimate survival and the local control of disease. There is, however, a subset of patients with advanced disease who respond to radiation therapy and whose survival is equivalent to our surgical cohort of patients.
OBJECTIVE: To compare the efficacy and treatment outcomes in patients with tonsillar fossa cancer using surgery or radiation as a single modality therapy. METHODS: From 1971 to 1991 239 patients with oral pharyngeal cancer were treated at Roswell Park Cancer Institute. Of these patients 90 had tonsillar carcinoma. Seventy-six of these patients received either surgery (SA) (n = 56) or radiation therapy (RA) (n = 20) as single-modality therapy and are the subject of this review. All patients in the radiation arm of this review were surgical candidates who declined primary surgical therapy. RESULTS: Sixty-three percent of the SA and 80% of the RA treatment groups presented with either stage III or stage IV disease (P < or = .05). Forty-seven percent of the SA group and 52% of the RA patients had clinically positive regional disease at initial presentation. There was a predictable pattern of nodal presentation, with level II the most frequently involved region. The rate of occult metastasis was 27% and was evenly distributed between T1 and T4 disease. The overall local control rate in the SA group was 75%, compared with 60% in the RA group (P value was not significant). The disease-specific survival (all stages) was 61% in the SA group and 37% in the RA group (P < or = .05). The disease-free survival for stage III and stage IV disease in the SA group was 47% and in the RA group 27% (P < or = .05). Survival measured against clinical response to radiation therapy, in complete responders (all stages) was 83%; by contrast there were no survivors past 24 months in the partial response group (P < or = .001). CONCLUSION: The results from this study suggest that for early disease (stage I/II), surgery or radiation therapy as single-modality treatment is equally effective. For advanced disease radiation therapy is inferior to surgery as a single-modality treatment, as measured by ultimate survival and the local control of disease. There is, however, a subset of patients with advanced disease who respond to radiation therapy and whose survival is equivalent to our surgical cohort of patients.
Authors: William R Kennedy; Michael P Herman; Rohan L Deraniyagala; Robert J Amdur; John W Werning; Peter Dziegielewski; Jessica Kirwan; Christopher G Morris; William M Mendenhall Journal: Eur Arch Otorhinolaryngol Date: 2016-04-08 Impact factor: 2.503
Authors: Rahmatullah Rahmati; Snjezana Dogan; Owen Pyke; Frank Palmer; Mahmoud Awad; Nancy Lee; Dennis H Kraus; Jatin P Shah; Snehal G Patel; Ian Ganly Journal: Head Neck Date: 2014-06-19 Impact factor: 3.147
Authors: Pierre Blanchard; Adam S Garden; G Brandon Gunn; David I Rosenthal; William H Morrison; Mike Hernandez; Joseph Crutison; Jack J Lee; Rong Ye; C David Fuller; Abdallah S R Mohamed; Kate A Hutcheson; Emma B Holliday; Nikhil G Thaker; Erich M Sturgis; Merrill S Kies; X Ronald Zhu; Radhe Mohan; Steven J Frank Journal: Radiother Oncol Date: 2016-06-21 Impact factor: 6.280
Authors: Gideon Y Bachar; Christopher Goh; David P Goldstein; Brian O'Sullivan; Jonathan C Irish Journal: Eur Arch Otorhinolaryngol Date: 2010-02 Impact factor: 2.503
Authors: Garrett L Jensen; Pierre Blanchard; G Brandon Gunn; Adam S Garden; C David Fuller; Erich M Sturgis; Maura L Gillison; Jack Phan; William H Morrison; David I Rosenthal; Steven J Frank Journal: Clin Transl Radiat Oncol Date: 2017-11-06