[Radiotherapy for 159 patients with carcinoma of the tonsils]

A series of 159 patients with carcinoma of the tonsil was treated by radiotherapy from Jan. 1970 to Dec. 1980. The overall 5, 10 and 15 year survival rates were 45.3% (72/159), 30.8% (32/104) and 34.8% (8/23). The 5 year survival rate was 62.5% (10/16), 68.9% (31/45), 39.0% (16/41) and 22.8% (12/57) for stages I, II, III and IV. There was no significance difference in the 5 year survival rates between undifferentiated (38/86, 44.2%) and squamous cell carcinomas (34/70, 48.6%). The majority of these patients received a dose of 50-70 Gy/6-8 weeks. Clinical stage and metastatic lymph node's size are the main factors influencing prognosis. The chief causes of failure: recurrence and distant metastasis totaled 73.2%, of which 11.3% metastasized into the abdomen. The authors believe that a large anterior tangential portal with a high upper margin is necessary to include the big metastasis in the subgastric lymph nodes on the homolateral neck region.