Fayos J V, Morales P
Int J Radiat Oncol Biol Phys. 1983 Feb;9(2):139-44. doi: 10.1016/0360-3016(83)90090-1.
From 1960 through 1976, 353 consecutive patients with carcinoma of the tonsillar region were primarily treated with radiation therapy. The mean age of patients was 58 years with males predominating (78%). Patients were classified according to a TNM and stage classification. Most of the tumors were large, and the specific site of origin could not be determined in 33% of the patients. The predominant identifiable sites were the soft palate and uvula, 18%, the anterior tonsillar pillar, 18%, and the tonsillar fossa, 13%. Patients were treated with radiation to doses of 6700 rad given in 48 days and 33 fractions using Cobalt 60 radiation. We found a 91.7% control rate for patients with T1 disease and 76.9%, 49.5%, and 25% for T2, T3, and T4 patients, respectively. The overall local control rate was 62.3%. Surgery was used most often in recurrences for Stage III patients. Salvage surgery was carried out in 93 patients. Surgery was more successful in controlling the disease in patients in whom the primary was controlled by irradiation. Overall, the tumors in 43% of the patients who had surgery were subsequently controlled as a result of this treatment. Metastasis occurred rapidly, with 75 of the patients exhibiting metastases by 18 months. Complications were not related to dose but were slightly higher in patients who had surgery (5%). We conclude that radiation therapy is the preferred treatment for Stage I and II squamous cell carcinoma of the tonsillar region. No satisfactory results were obtained in Stage IV; other approaches should be tried.
从1960年到1976年，353例连续性扁桃体区域癌患者主要接受放射治疗。患者的平均年龄为58岁，男性居多（78%）。患者根据TNM和分期分类进行划分。大多数肿瘤体积较大，33%的患者无法确定肿瘤的具体起源部位。最常见的可识别部位是软腭和悬雍垂，占18%，扁桃体前柱占18%，扁桃体窝占13%。患者使用钴60放疗，在48天内分33次给予6700拉德的剂量。我们发现T1期疾病患者的控制率为91.7%，T2、T3和T4期患者的控制率分别为76.9%、49.5%和25%。总体局部控制率为62.3%。手术最常用于III期患者的复发情况。93例患者接受了挽救性手术。对于原发灶通过放疗得到控制的患者，手术在控制疾病方面更成功。总体而言，43%接受手术的患者的肿瘤随后因该治疗而得到控制。转移发生迅速，75例患者在18个月时出现转移。并发症与剂量无关，但接受手术的患者并发症发生率略高（5%）。我们得出结论，放射治疗是扁桃体区域I期和II期鳞状细胞癌的首选治疗方法。IV期未取得满意结果；应尝试其他方法。
