Carcinoma of the tonsillar region. Aspects on treatment modalities with reference to a study on patients treated by irradiation.

Irradiation is the most common form of treatment of tonsillar region carcinomas in Scandinavia. During recent years, encouraging results have been reported when surgery has been performed. Therefore, an effort was made to compare different treatment principles on the basis of a study on patients treated by irradiation. This retrospective study comprised 37 patients over a 20-year period. The relative 5-year survival was 33%. Most of the patients died in the next two years after diagnosis. Seventy-three percent of the patients initially had signs of regional metastasis. Hardly 20% of these were still alive after 5 years, while patients without evidence of metastasis had a 5-year survival of 50%. Neither the size, nor the histopathological features of the primary tumor seemed to affect the incidence of regional metastasis. The duration of symptoms before diagnosis, however, seemed to influence prognosis. Surgical consideration alone, or in combination with irradiation, should be made in cases with large primary tumor with regional lymph node involvement. In other cases, however, there was no evidence suggesting surgery as a better form of therapy than irradiation alone.