Lee W R, Mendenhall W M, Parsons J T, Million R R, Cassisi N J, Stringer S P
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville.
Head Neck. 1993 Jul-Aug;15(4):283-8. doi: 10.1002/hed.2880150402.
Between October 1964 and June 1990, 243 patients with squamous cell carcinoma of the tonsillar region were treated with continuous-course radical radiotherapy at the University of Florida. All patients had a minimum 2-year follow-up. Patients were staged according to the AJCC system; stage IV was stratified into two subsets: favorable, IVA (T1-T3 or N2A-N3A); and unfavorable, IVB (T4 or N3B). The initial and ultimate local control rates (including surgical salvage) according to T stage were as follows: T1, 87% and 100%, T2, 79% and 92%; T3, 71% and 76%; and T4, 44% and 48%. Multivariate analysis demonstrated that anterior extension of the primary tumor (p = .0001) and T stage (p = .014) were the most significant parameters affecting local control after radiotherapy. For T4 lesions, twice-daily irradiation significantly improved local control (p = .04). The 5-year absolute and cause-specific survival rates as a function of modified AJCC stage were as follows: I, 37% and 100%; II, 55% and 90%; III, 55% and 85%; IVA, 35% and 60%; and IVB, 23% and 38%. The probability of a severe complication was 3% for the entire group of patients.
1964年10月至1990年6月期间，243例扁桃体区鳞状细胞癌患者在佛罗里达大学接受了连续疗程的根治性放疗。所有患者均至少随访2年。患者根据美国癌症联合委员会（AJCC）系统进行分期；IV期分为两个亚组：有利的IVA期（T1-T3或N2A-N3A）；不利的IVB期（T4或N3B）。根据T分期的初始和最终局部控制率（包括手术挽救）如下：T1期，87%和100%；T2期，79%和92%；T3期，71%和76%；T4期，44%和48%。多变量分析表明，原发肿瘤向前扩展（p = 0.0001）和T分期（p = 0.014）是放疗后影响局部控制的最显著参数。对于T4期病变，每日两次照射显著提高了局部控制率（p = 0.04）。根据改良AJCC分期的5年绝对生存率和病因特异性生存率如下：I期，37%和100%；II期，55%和90%；III期，55%和85%；IVA期，35%和60%；IVB期，23%和38%。整个患者组严重并发症的发生率为3%。
