RESULTATI DELLA TELECOBALTOTERAPIA NEL TRATTAMENTO DEI CARCINOMI DELL'OROFARINGE

A clinical retrospective evaluation of 177 cases of carcinoma of the oropharynx treated with Cobalt therapy from 1959 to 1965 was made. The analysis of long term results has shown that Cobalt therapy alone does not satisfactorily control carcinomas of the oropharynx. In fact, less than 30% of the patients are still alive after 3 years. Survival is directly affected by the local extent of disease since, while the 5 year survival of T1 and T2 cases is respectively 26.8% and 21.5%, only 6.5% of patients with T3 carcinomas are still alive after 5 years. Particularly disappointing is the survival rate in cases with mono or bilateral involvement of neck nodes, since none of these cases are alive 2 years after the initial therapy. In 69.4% of the cases, treatment failure has to be attributed to minimal response or early recurrence of primary tumor, while lymph node relapses have been observed in more than 25% of the cases. To allow a detailed clinical evaluation of the results, the different regions of the oropharynx should be considered separately, since differences in clinical evolution of various carcinomas would call for a different therapeutic approach. The results of this study in oropharyngeal carcinomas, indicate that improvement of long term results may only be obtained through a multidisciplinary therapeutic approach.