Oropharyngeal carcinoma treated with radiotherapy: A 30-year experience

Purpose: This study was done to determine the outcome in patients with oropharyngeal carcinoma treated at the University of Florida with radiotherapy alone to the primary site, for comparison with reported results of other types of treatment. Methods and Materials: Of a consecutive cohort of 785 patients with biopsy-proven, previously untreated, invasive squamous cell carcinoma of the oropharynx, this report is based on the 490 patients who had continuous-course irradiation with curative intent at the University of Florida between October 1964 and January 1991, All patients had a minimum 2-year follow-up, Forty-eight percent had Stage T3 or T4 disease, and 64% had clinically apparent neck node metastases, The median radiation dose was 68 Gy for once-a-day treatment and 76.8 Gy for twice-a-day treatment, Patients with advanced neck node disease had planned neck dissection(s) after radiotherapy. Results: The overall local control rate after radiotherapy alone was 73%, The ultimate local control rate (including surgical salvage) was 78%. At 5 years, the probability of control of neck disease was 85%; control above the clavicles, 67%; absolute survival, 44%; cause-specific survival, 77%; distant metastasis (as the first or only site of failure), 11%, Thirteen patients (2.6%) experienced severe treatment complications. Conclusion: Radiotherapy results in tumor control and survival rates comparable with rates achieved with combined irradiation and surgery, with less morbidity.