Squamous cell carcinoma of the oropharynx
Surgery, radiation therapy, or both
The treatment of patients with squamous cell carcinoma (SCC) of the oropharynx remains controversial. No randomized trial has addressed adequately the question of whether surgery (S), radiation therapy (RT), or combined treatment is most effective.

Treatment results from North American academic institutions that used S with or without adjuvant RT (S RT) or used RT alone or followed by neck dissection (RT ND) for patients with SCC of the tonsillar region or the base of tongue were compiled. Results and conclusions were based on data from 51 reported series, representing the treatment of approximately 6400 patients from the United States and Canada. Results in tables below:

CONCLUSIONS The information in this article provides a useful benchmark for evidence-based counseling of patients with SCC of the oropharynx. The rates of local control, local-regional control, 5-year survival, and 5-year cause specific survival were similar for patients who underwent S RT or RT ND, whereas the rates of severe or fatal complications were significantly greater for the S RT group. Furthermore, available data on the functional consequences of treatment suggest the superiority of RT ND. The authors conclude that RT ND is preferable for the majority of patients with SCC of the oropharynx.    Parsons. Cancer 2002;94:2967-80

Base of Tongue Cancer
  Surgery Radiation
local control 79% 76%
local-regional control 60% 69%
5 year survival 49% 52%
5y cuase specific survival 62% 63%
severe complications 32% 3.8%
fatal complications 3.5% 0.4%

Tonsil Cancer
  Surgery Radiation
local control 70% 68%
local-regional control 65% 69%
5 year survival 47% 43%
5y cuase specific survival 57% 59%
severe complications 23% 6%
fatal complications 3.2% 0.8%


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