Primary Radiotherapy for Tonsillar Carcinoma: A Good Alternative to a Surgical Approach
Bibliographic record
Abstract
OBJECTIVES: To review the Notre-Dame hospital experience in the treatment of tonsillar carcinoma with primary radiotherapy and to evaluate the different factors affecting locoregional control (LRC) and survival. METHODS: We reviewed the records of 164 patients treated consecutively for squamous cell carcinoma of the tonsillar region between January 1990 and June 1999. Our study included 22 T1, 75 T2, 54 T3, and 12 T4 lesions; according to N stage, there were 48 N0, 50 N1, 51 N2, and 15 N3 disease. Overall staging was 6 stage I, 28 stage II, 62 stage III, and 67 stage IV disease. All patients received curative radiotherapy, and 31 patients received chemotherapy either prior to or during treatment with radiotherapy. No patient received surgery as a primary treatment modality. RESULTS: The median follow-up was 4.2 years for all patients and 5.4 years for alive patients. The overall LRC rate was 72% at 5 years. By T and N stage, local and regional control rates at 5 years were as follows: T1, 82%; T2, 74%; T3, 66%; T4, 65%; N0, 77%; N1, 83%; N2, 65%; and N3, 38%. Significant favourable prognostic factors for LRC on univariate analysis were N stage and global stage. On multivariate analysis, the single favourable prognostic factor was N stage. The overall survival (OS) rate was 57% at 5 years. By T and N stage, OS at 5 years was as follows: T1, 62%; T2, 67%; T3, 45%; T4, 22%; N0, 63%; N1, 70%; N2, 46%; and N3, 32%. Significant prognostic factors for OS on univariate analysis were T stage, N stage, and global stage. Favourable prognostic factors for OS on multivariate analysis were T stage and N stage. CONCLUSION: Lower N stage was a favourable prognostic factor for LRC and OS, whereas lower T stage was a favourable prognostic factor on OS. Our results compare favourably with other single-institution surgical series and justify the role of radiotherapy as a primary treatment modality in early tonsillar carcinoma. Concurrent chemotherapy and radiation therapy is currently our standard of care in advanced tonsillar carcinoma.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".