Background A study was needed to determine the effect of primary tumor volume on local control of oropharyngeal carcinoma treated with radiation therapy, with or without induction chemotherapy. Methods Between July 1983 and April 1995, 114 patients with T2–T4 squamous cell carcinoma of the oropharynx were treated for cure with radiation therapy, with or without induction chemotherapy, and had a pretreatment CT scan available for retrospective review. All scans were reviewed by a single radiologist (A. A. M.) to determine the tumor volume of the primary lesion. Volume was measured with a computer digitizer for each CT slice showing the primary lesion. Results A large variation in tumor volume within a given T stage was found. Multivariate analysis demonstrated T stage to be the most significant factor affecting local control. Tumor volume marginally influenced local control (p = .10). Conclusions Primary tumor volume varies significantly within a given T stage and has a marginal impact on the likelihood of local control after radiotherapy. © 2000 John Wiley & Sons, Inc. Head Neck 22: 1–5, 2000.

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