ABSTRACT

The aim of this study was to compare the treatment results of patients with T4 staged tonsillar carcinoma who underwent either surgery combined with radiotherapy and chemotherapy or primary radiotherapy combined with chemotherapy.

Twenty-one patients included in the study who treated for T4a tonsillar carcinoma in curative intend. Nine of these patients underwent surgery and adjuvant radiotherapy and chemotherapy and 12 of these patients received primary radiotherapy combined with chemotherapy.

The locoregional recurrence rates of patients who underwent surgery and who received primary radiotherapy were 77% and 75% respectively. By using Kaplan-Meier survival analysis, 2 and 3 years disease-specific survival rates of patients who underwent surgery were 73% and 45% respectively. Two and 3 years disease-specific survival rates of patients who received primary radiotherapy combined with chemotherapy were 67% and 42% respectively.

Radical surgery with postoperative radiotherapy and chemotherapy has been slowly replaced by primary radiotherapy with concurrent chemotherapy for advanced oropharyngeal carcinoma. Our results confirm that our clinical approach should also change towards primary radiotherapy and chemotherapy instead of radical surgery.

Keywords: Total Laryngectomy, Tracheoesophageal Puncture, Voice Rehabilitation