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Title: Unilateral Radiotherapy for the Treatment of Tonsil Cancer

Abstract

Purpose: To assess, through a retrospective review, clinical outcomes of patients with squamous cell carcinoma of the tonsil treated at the M. D. Anderson Cancer Center with unilateral radiotherapy techniques that irradiate the involved tonsil region and ipsilateral neck only. Methods and Materials: Of 901 patients with newly diagnosed squamous cell carcinoma of the tonsil treated with radiotherapy at our institution, we identified 102 that were treated using unilateral radiotherapy techniques. All patients had their primary site of disease restricted to the tonsillar fossa or anterior pillar, with <1 cm involvement of the soft palate. Patients had TX (n = 17 patients), T1 (n = 52), or T2 (n = 33) disease, with Nx (n = 3), N0 (n = 33), N1 (n = 23), N2a (n = 21), or N2b (n = 22) neck disease. Results: Sixty-one patients (60%) underwent diagnostic tonsillectomy before radiotherapy. Twenty-seven patients (26%) underwent excision of a cervical lymph node or neck dissection before radiotherapy. Median follow-up for surviving patients was 38 months. Locoregional control at the primary site and ipsilateral neck was 100%. Two patients experienced contralateral nodal recurrence (2%). The 5-year overall survival and disease-free survival rates were 95% and 96%, respectively. Themore » 5-year freedom from contralateral nodal recurrence rate was 96%. Nine patients required feeding tubes during therapy. Of the 2 patients with contralateral recurrence, 1 experienced an isolated neck recurrence and was salvaged with contralateral neck dissection only and remains alive and free of disease. The other patient presented with a contralateral base of tongue tumor and involved cervical lymph node, which may have represented a second primary tumor, and died of disease. Conclusions: Unilateral radiotherapy for patients with TX-T2, N0-N2b primary tonsil carcinoma results in high rates of disease control, with low rates of contralateral nodal failure and a low incidence of acute toxicity requiring gastrostomy.« less

Authors:
 [1]; ; ;  [1];  [2]; ; ;  [1];  [3]; ;  [1]
  1. Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  2. Department of Radiation Medicine, Long Island Jewish Hospital (United States)
  3. Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
22056330
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 83; Journal Issue: 1; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; FAILURES; IRRADIATION; LYMPH NODES; NECK; PATIENTS; PHARYNX; RADIOTHERAPY; TONGUE; TOXICITY

Citation Formats

Chronowski, Gregory M., E-mail: gchronowski@mdanderson.org, Garden, Adam S., Morrison, William H., Frank, Steven J., Schwartz, David L., Shah, Shalin J., Beadle, Beth M., Gunn, G. Brandon, Kupferman, Michael E., Ang, Kian K., and Rosenthal, David I.. Unilateral Radiotherapy for the Treatment of Tonsil Cancer. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.06.1975.
Chronowski, Gregory M., E-mail: gchronowski@mdanderson.org, Garden, Adam S., Morrison, William H., Frank, Steven J., Schwartz, David L., Shah, Shalin J., Beadle, Beth M., Gunn, G. Brandon, Kupferman, Michael E., Ang, Kian K., & Rosenthal, David I.. Unilateral Radiotherapy for the Treatment of Tonsil Cancer. United States. doi:10.1016/J.IJROBP.2011.06.1975.
Chronowski, Gregory M., E-mail: gchronowski@mdanderson.org, Garden, Adam S., Morrison, William H., Frank, Steven J., Schwartz, David L., Shah, Shalin J., Beadle, Beth M., Gunn, G. Brandon, Kupferman, Michael E., Ang, Kian K., and Rosenthal, David I.. Tue . "Unilateral Radiotherapy for the Treatment of Tonsil Cancer". United States. doi:10.1016/J.IJROBP.2011.06.1975.
@article{osti_22056330,
title = {Unilateral Radiotherapy for the Treatment of Tonsil Cancer},
author = {Chronowski, Gregory M., E-mail: gchronowski@mdanderson.org and Garden, Adam S. and Morrison, William H. and Frank, Steven J. and Schwartz, David L. and Shah, Shalin J. and Beadle, Beth M. and Gunn, G. Brandon and Kupferman, Michael E. and Ang, Kian K. and Rosenthal, David I.},
abstractNote = {Purpose: To assess, through a retrospective review, clinical outcomes of patients with squamous cell carcinoma of the tonsil treated at the M. D. Anderson Cancer Center with unilateral radiotherapy techniques that irradiate the involved tonsil region and ipsilateral neck only. Methods and Materials: Of 901 patients with newly diagnosed squamous cell carcinoma of the tonsil treated with radiotherapy at our institution, we identified 102 that were treated using unilateral radiotherapy techniques. All patients had their primary site of disease restricted to the tonsillar fossa or anterior pillar, with <1 cm involvement of the soft palate. Patients had TX (n = 17 patients), T1 (n = 52), or T2 (n = 33) disease, with Nx (n = 3), N0 (n = 33), N1 (n = 23), N2a (n = 21), or N2b (n = 22) neck disease. Results: Sixty-one patients (60%) underwent diagnostic tonsillectomy before radiotherapy. Twenty-seven patients (26%) underwent excision of a cervical lymph node or neck dissection before radiotherapy. Median follow-up for surviving patients was 38 months. Locoregional control at the primary site and ipsilateral neck was 100%. Two patients experienced contralateral nodal recurrence (2%). The 5-year overall survival and disease-free survival rates were 95% and 96%, respectively. The 5-year freedom from contralateral nodal recurrence rate was 96%. Nine patients required feeding tubes during therapy. Of the 2 patients with contralateral recurrence, 1 experienced an isolated neck recurrence and was salvaged with contralateral neck dissection only and remains alive and free of disease. The other patient presented with a contralateral base of tongue tumor and involved cervical lymph node, which may have represented a second primary tumor, and died of disease. Conclusions: Unilateral radiotherapy for patients with TX-T2, N0-N2b primary tonsil carcinoma results in high rates of disease control, with low rates of contralateral nodal failure and a low incidence of acute toxicity requiring gastrostomy.},
doi = {10.1016/J.IJROBP.2011.06.1975},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 83,
place = {United States},
year = {Tue May 01 00:00:00 EDT 2012},
month = {Tue May 01 00:00:00 EDT 2012}
}