Mendenhall W M, Parsons J T, Cassisi N J, Million R R
Division of Radiation Therapy, University of Florida College of Medicine, Gainesville 32610.
Radiother Oncol. 1987 Sep;10(1):23-30. doi: 10.1016/s0167-8140(87)80066-x.
This is an analysis of 136 patients treated with radiation therapy alone (104) or in conjunction with planned neck dissection (32) for squamous cell carcinoma of the tonsillar area between October 1964 and August 1983. All patients have a 2-year follow-up and 94 (69%) have a minimum 5-year follow-up. Patients were excluded from analysis of disease control at the primary site and/or neck if they died within 2 years of treatment with that site continuously disease-free. All patients were treated with continuous-course irradiation; those treated with the planned split-course technique are not included. Once-a-day fractionation was used in 105 patients and twice-a-day fractionation in 31 patients. External beam alone was used in 93 patients, and external beam followed by a radium needle implant boost to the primary site was employed in 43 patients. Rates of initial local control with irradiation and ultimate local control after surgical salvage of irradiation failures are as follows: T1, 10/12 (83%) and 12/12; T2, 36/46 (78%) and 41/46 (89%); T3, 28/39 (72%) and 28/39 (72%); T4, 5/16 (31%) and 5/16 (31%). Local control data are also presented as a function of tumor site within the tonsillar area, total dose, dose per fraction, and external beam alone versus external beam plus radium needle implant. The 5-year determinate survival rates by modified AJCC stage are as follows: I, 3/3; II, 13/14; III, 14/17; IVA, 6/14; and IVB, 4/19.
这是一项对136例患者的分析，这些患者于1964年10月至1983年8月期间因扁桃体区鳞状细胞癌接受单纯放射治疗（104例）或联合计划性颈部清扫术（32例）。所有患者均有2年随访，94例（69%）有至少5年随访。如果患者在治疗后2年内死亡且该部位持续无病，则被排除在原发部位和/或颈部疾病控制分析之外。所有患者均接受连续疗程照射；不包括采用计划性分割疗程技术治疗的患者。105例患者采用每日一次分割照射，31例患者采用每日两次分割照射。93例患者仅使用外照射，43例患者采用外照射后对原发部位进行镭针植入加强照射。照射后的初始局部控制率和照射失败后手术挽救后的最终局部控制率如下：T1期，10/12（83%）和12/12；T2期，36/46（78%）和41/46（89%）；T3期，28/39（72%）和28/39（72%）；T4期，5/16（31%）和5/16（31%）。局部控制数据也作为扁桃体区内肿瘤部位、总剂量、每次分割剂量以及仅外照射与外照射加镭针植入的函数呈现。根据改良AJCC分期的5年确定生存率如下：I期，3/3；II期，13/14；III期，14/17；IVA期，6/14；IVB期，4/19。
