Clinico-statistical analysis of rhinopharyngeal neoplasms treated by radiotherapy from 1928 to 1963 (314 cases)

Abstract

Results obtained by radiotherapy in 314 cases of rhinopharyngeal neoplasms treated from 1928 to 1963 at the Institute of Radiology of the Medical School and at the National Cancer Institute are presented. The series of cases includes 61 epithelial neoplasms, 117 rhinopharyngiomas, 112 connective neoplasms and 24 cases non histologically proved. In 41.7 % of the cases regional lymph node invasion was the first sign of the disease. Regional lymph node involvement was present at the beginning of radiotherapy in 72.5 % of the cases. Sixty-eight cases, hospitalized from 1928 to 1945, were prevailingly treated with endocavitary radiumtherapy and by roentgentherapy. One hundred and sixty cases, hospitalized from 1946 to 1958, were treated by various procedures and, in the last years, almost exclusively by multiple small fields roentgentherapy and by convergent roentgentherapy. Most of the 80 cases treated from 1959 to 1963 were submitted to telecobalt therapy. In the connective neoplasms (lympho- and reticulosarcomas) the overall 3-year and 5-year survival rate has been 34.2 % and 28.5 % respectively. In particular, cases without regional lymph node invasion at the beginning of the treatment had a 5-year survival rate of 61.5 %, opposite to 15.4 % in patients with lymph node metastases. In the other histological forms (rhinopharyngiomas, epitheliomas and non ascertained cases) the overall 3-year survival was 28 %, and the 5-year survival 19.6 %. In patients showing no lymph node involvement at the beginning of the treatment the 5-year survival rate was 37.8 %, in those with unilateral invasion 15.8 %, and in those with bilateral lymph node metastases 5.8 %. In epithelial neoplasms, the 5-year survival was 12.5 % in patients who had, at the beginning of the treatment, neurological or radiological signs of metastases to the base of the skull, and 21.9 % in patients, without involvement of the base of the skull. A statistical analysis of the results obtained in the various periods showed a more favourable outcome in patients treated by telecobalt therapy, as demonstrated both by average life and 3-year and 5-year survival rates.