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No randomized trial has addressed adequately the question of whether surgery (S), radiation therapy (RT), or combined treatment is most effective.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Treatment results from North American academic institutions that used S with or without adjuvant RT (S \u00b1 RT) or used RT alone or followed by neck dissection (RT \u00b1 ND) for patients with SCC of the tonsillar region or the base of tongue were compiled through a MEDLINE search (from 1970 to August, 2000) and from the references cited in each report. Studies were eligible for inclusion if they contained direct, actuarial (life\u2010table), or Kaplan\u2013Meier calculations for the following end points: local control, local\u2010regional control, 5\u2010year absolute survival, 5\u2010year cause specific survival, or severe or fatal treatment complications. Weighted average results, which took into account series size, were calculated for each end point for the purposes of treatment comparison. Results and conclusions were based on data from 51 reported series, representing the treatment of approximately 6400 patients from the United States and Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The results for patients with SCC of the <jats:italic>base of tongue<\/jats:italic> who underwent S \u00b1 RT versus RT \u00b1 ND, respectively, were as follows: local control, 79% versus 76% (<jats:italic>P<\/jats:italic> = 0.087); local\u2010regional control, 60% versus 69% (<jats:italic>P<\/jats:italic> = 0.009); 5\u2010year survival, 49% versus 52% (<jats:italic>P<\/jats:italic> = 0.2); 5\u2010year cause specific survival, 62% versus 63% (<jats:italic>P<\/jats:italic> = 0.4); severe complications, 32% versus 3.8% (<jats:italic>P<\/jats:italic> &lt; 0.001); and fatal complications, 3.5% versus 0.4% (<jats:italic>P<\/jats:italic> &lt; 0.001). The results for patients with SCC in the <jats:italic>tonsillar region<\/jats:italic> who underwent S \u00b1 RT versus RT \u00b1 ND, respectively, were as follows: local control, 70% versus 68% (<jats:italic>P<\/jats:italic> = 0.2); local\u2010regional control, 65% versus 69% (<jats:italic>P<\/jats:italic> = 0.1); 5\u2010year survival, 47% versus 43% (<jats:italic>P<\/jats:italic> = 0.2); 5\u2010year cause specific survival, 57% versus 59% (<jats:italic>P<\/jats:italic> = 0.3); severe complications, 23% versus 6% (<jats:italic>P<\/jats:italic> &lt; 0.001); and fatal complications, 3.2% versus 0.8% (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The information in this article provides a useful benchmark for evidence\u2010based counseling of patients with SCC of the oropharynx. The rates of local control, local\u2010regional control, 5\u2010year survival, and 5\u2010year cause specific survival were similar for patients who underwent S \u00b1 RT or RT \u00b1 ND, whereas the rates of severe or fatal complications were significantly greater for the S \u00b1 RT group. Furthermore, available data on the functional consequences of treatment suggest the superiority of RT \u00b1 ND. The authors conclude that RT \u00b1 ND is preferable for the majority of patients with SCC of the oropharynx. Cancer 2002;94:2967\u201380. \u00a9 2002 American Cancer Society.<\/jats:p><jats:p>DOI 10.1002\/cncr.10567<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.10567","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T19:29:46Z","timestamp":1030303786000},"page":"2967-2980","source":"Crossref","is-referenced-by-count":384,"title":["Squamous cell carcinoma of the oropharynx"],"prefix":"10.1002","volume":"94","author":[{"given":"James T.","family":"Parsons","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Mendenhall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott P.","family":"Stringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Amdur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell 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