To evaluate the treatment of advanced tonsillar carcinoma by radiotherapy plus salvage surgery (R+S) or surgery coupling with postoperative radiotherapy (S+R).Clinical data of 48 patients with advanced tonsillar carcinoma who were treated in The 2nd Affiliated Hospital of Sun Yat-sen University from June 1996 to June 2004 was retrospectively analyzed. The patients were divided into R+S group (group A, 21 cases) and S+R group (group B, 27 cases). Treatment outcomes were compared between these two groups. The QOL (quality of life) scale of Washington University (UW-QOL) was used to investigate the patient's quality of life.The 5-year survival rates were 42.9% in group A and 45.8% in group B, there was no significant statistical difference between the two groups (P0.05). Both the two treatment modalities could reduce the QOL in some degree. The average QOL score of 46 patients was 661.00 +/- 98.52 , group A was 696.09 + 90.70, while group B was 631.52 +/- 96.74, there was a significant statistical difference between the two groups (P0.05).The two treatment modalities reached similar survivals. However, compared with the S+R, some patients who accepted treatment of R+S could avoid composite resection, reduce functional lesion and improve the QOL.