Surgical salvage for radiation failure cases of oropharynx carcinoma

From 1967 through 1982, one hundred and seventy six patients with squamous cell carcinoma and anaplastic carcinoma of oropharynx were treated at the Departments of Otolaryngology and Radiology, Osaka University Hospital.All cases were initially treated by external radiation therapy. Recurrent cases were treated by various kinds of treatment, such as surgery, interstitial iradiation or external radiation. Surgical treatment was most effective in the management of recurrent cases.Local lesions were controlled in 77 cases by the initial radiation alone. Out of 99 recurrent cases, 25 cases were treated by surgical procedures, of which 14 cases were successfully controlled. Local control rate by radiation therapy was found to decrease as the size of the tumor increases. Local control rates according to T stage were T1: 60%, T2: 51%, T3: 32%, T4: 0%.Radical radiation therapy can be curative in the early stages while preserving function, whereas, surgery alone, or in combination with radiation therapy should be performed in advanced stages.