Johnston W D, Byers R M
Cancer. 1977 Feb;39(2):632-6. doi: 10.1002/1097-0142(197702)39:2<632::aid-cncr2820390239>3.0.co;2-9.
Squamous cell carcinoma of the tonsil is rare in people under 40 years of age. Only 11 cases have been treated at the M.D. Anderson Hospital since 1944. Their 5-year survival was decreased (14%) when compared to the total group of patients treated for squamous cell carcinoma of the tonsil (48%). Young adults had higher clinical staging than the total group. Ninety-one percent of the young patients had neck nodal metastasis, with 55% staged N3. Of the entire group, 76% had neck nodal metastasis with 23% staged N3. Case histories indicate a lack of suspicion of tonsillar cancer on the part of patients and physicians. The average total delay from symptoms to diagnosis was 11 months. Response rates of radiotherapy alone were excellent (no failures) in patients with staging T1, T2, TX, N0, and N1. However, five (45%) of the 11 young patients had T3 or T4 primaries and all died, four with regional failure. Six of the 11 young patients had N3 staging and five of these died, all with regional failure except one. Planned combined treatment should be used more frequently in young adults with high staging.
扁桃体鳞状细胞癌在40岁以下人群中较为罕见。自1944年以来，MD安德森医院仅治疗过11例此类病例。与扁桃体鳞状细胞癌的总体治疗患者相比，他们的5年生存率有所下降（14%），而总体患者的5年生存率为48%。年轻成年人的临床分期高于总体患者。91%的年轻患者有颈部淋巴结转移，其中55%为N3期。在整个患者群体中，76%有颈部淋巴结转移，23%为N3期。病例记录显示患者和医生对扁桃体癌缺乏警惕。从出现症状到确诊的平均总延迟时间为11个月。对于T1、T2、TX、N0和N1期的患者，单纯放疗的缓解率极佳（无治疗失败）。然而，11例年轻患者中有5例（45%）为T3或T4期原发性肿瘤，均死亡，其中4例死于局部复发。11例年轻患者中有6例为N3期，其中5例死亡，除1例患者外均死于局部复发。对于高分期的年轻成年人，应更频繁地采用计划性联合治疗。
