ODGKIN LYMPHOMA IS 1 OF the first cancers in which high cure rates were achieved with both radiation and chemotherapy. With longer follow-up, it is apparent that survivors carry risks for treatment-related effects that may not manifest until many years later. The focus of therapeutic trials in most stages of the disease has now shifted from a search for more effective therapy to a search for less toxic therapy. Documentation of the incidence and severity of these late complications, as well as contributing factors, is crucial in surveillance and intervention for late treatment effects in patients already treated, as well as prevention of late effects in future patients through optimal individual treatment decisions and clinical trial design. Several studies have reported an increase in premature death from myocardial infarction among patients treated for Hodgkin lymphoma with mediastinal radiotherapy. 1-8 Reports of valvular disease 9-14 and peripheral vascular disease 15,16 after radiotherapy have been sporadic. Our study was designed to estimate the incidence, severity, and risk factors associated with 3 potential radiation treatment-related complica-Author Affiliations are listed at the end of this article.

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BACKGROUND. In the current study,the authors analyzed the results of definitive radiotherapy for squamous cell carcinoma of the pharyngeal wall. METHODS. Between 1964 and 2000, 148 patients were treated with definitive radiotherapy. All patients had a 2-year minimum follow-up. RESULTS. The following 5-year rates of local and ultimate local control were obtained: T1 disease, 93% and 93%; T2 disease, 82% and 87%; T3 disease, 59% and 61%; and T4 disease, 50% and 50%, respectively. Multivariate analysis revealed that twice-daily fractionation (P ϭ 0.0009), American Joint Committee on Cancer Stage I-II disease (P ϭ 0.0051), and oropharyngeal primary site (P ϭ 0.0193) were associated with improved locoregional control. The following 5-year absolute and cause-specific survival rates were obtained: Stage I, 56% and 89%; Stage II, 52% and 88%; Stage III, 24% and 44%; Stage IV, 22% and 34%; and overall, 30% and 49%, respectively. Eight patients (5%) died of complications.. CONCLUSIONS. Locoregional control and survival were found to be related to site, extent of disease, and fractionation schedule. Although outcomes have improved in recent years, the morbidity of treatment was significant in the current study and a substantial proportion of patients died secondary to the malignancy. Cancer

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