Definitive radiotherapy alone or combined with a planned neck dissection for squamous cell carcinoma of the pharyngeal wall

BACKGROUND: In the current study,the authors analyzed the results of definitive radiotherapy for squamous cell carcinoma of the pharyngeal wall. METHODS: Between 1964 and 2000, 148 patients were treated with definitive radiotherapy. All patients had a 2-year minimum follow-up. RESULTS: The following 5-year rates of local and ultimate local control were obtained: T1 disease, 93% and 93%; T2 disease, 82% and 87%; T3 disease, 59% and 61%; and T4 disease, 50% and 50%, respectively. Multivariate analysis revealed that twice-daily fractionation (P = 0.0009), American Joint Committee on Cancer Stage I-II disease (P = 0.0051), and oropharyngeal primary site (P = 0.0193) were associated with improved locoregional control. The following 5-year absolute and cause-specific survival rates were obtained: Stage I, 56% and 89%; Stage II, 52% and 88%; Stage III, 24% and 44%; Stage IV, 22% and 34%; and overall, 30% and 49%, respectively. Eight patients (5%) died of complications. CONCLUSIONS: Locoregional control and survival were found to be related to site, extent of disease, and fractionation schedule. Although outcomes have improved in recent years, the morbidity of treatment was significant in the current study and a substantial proportion of patients died secondary to the malignancy.