Analysis of the results of irradiation in the treatment of squamous cell carcinomas of the pharyngeal walls. [. gamma. rays; x rays; and 12 to 19 MeV electrons]

This study is a retrospective analysis of the results of definitive treatment with irradiation alone or in combination with surgery for patients with squamous cell carcinoma of the pharyngeal walls. For the 164 patients who were treated with irradiation alone, the failure rate ranged from 9% for T1 lesions to 63% for T4 lesions. Surgical salvage was successful in 11 of the 66 patients in whom radiotherapy failed at the primary site. Fatal complications developed in 5% of the patients, mostly in those with an advanced primary tumor or neck disease who underwent surgery following failure of radiotherapy. For T3 or T4 lesions, in 20 patients treated with a combination of irradiation and surgery, the failure rate for treatment of the primary tumor was 25% compared with 49% of 108 patients who were treated with radiotherapy alone, but the patients were not randomized. Treatment recommendations are as follows: For T1 and T2 lesions, radiotherapy alone with a tumor dose of 6500 rad in 6.5 weeks and 7000 rad in 7 weeks respectively. For operable T3 and T4 lesions a combination of surgery and irradiation is suggested. For unresectable T3 and T4 lesions, a tumor dose of 7500 rad is suggestedmore » with consideration given to experimental radiotherapy techniques.« less