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May 24, 1965

Cobalt 60 Irradiation for Advanced Carcinoma of the Palatine Tonsil

Author Affiliations

From the Department of Radiology, University of Louisville School of Medicine, Louisville, Ky. Dr. Brizel is an advanced clinical fellow of the American Cancer Society.

JAMA. 1965;192(8):723-725. doi:10.1001/jama.1965.03080210067026

CARCINOMA of the palatine tonsil is the second most common malignancy of the oropharynx. Early lesions have an excellent chance for cure but offer difficulty in diagnosis. The majority develop insidiously and present as advanced disease, both locally and by cervical adenopathy.

Carcinoma originating in the tonsillar fossa can easily spread to the anterior and posterior pillars, pharyngeal wall, soft palate, tongue, gingiva, and mandible. Because of the rich lymphatic supply of the region, lymph node metastases are a common presenting sign.1

Until recently, irradiation and surgery have had little to offer in the advanced cases. A high percentage of postoperative complications followed the required ultraradical resection. Radiotherapy, without the general availability of supervoltage or telecobalt, encountered difficulties in delivering a tumorcidal dose to the required large volume without damage to the normal surrounding bone and soft tissue.

In recent years there has been a renaissance of the surgical