An analysis of factors in the successful management of cancer of tonsillar region.

A total of 117 consecutive primary cancers of the tonsillar region was irradiated at the University of Illinois Hospitals from 1955 to 1973. Results with 94 patients treated with radiotherapy alone and 23 with a combination of surgery and radiotherapy were analyzed. The modalities of radiation used were electron beam, 22 meV photons and Cobalt-60. Lymph node metastases were noted in 70% of the patients at the initial examination. In patients treated with radiation alone the determinant 5-year survivals were 42% without and 20% with nodal involvement. In the absence of node disease, survivals were 100% in T1, 60% in T2, 37.5% in T3 and 25% in T4 lesions. The significance of age, sex, histological differentiation, extent of the tumor, modality of treatment and the incidence of second primary were analyzed. Time dose relationships and factors influencing the prognosis are discussed and the literature is reviewed.