Abstract
The purpose of this study is to update our institution’s experience with ipsilateral radiation therapy (RT) for squamous cell carcinoma of the tonsillar area. Outcome study of 76 patients treated between 1984 and 2012 with ipsilateral RT for squamous cell carcinoma of the tonsil. Patients had either cT1 (n = 41, 54 %) or cT2 (n = 35, 46 %) primaries and cN0 (n = 27, 36 %), cN1 (n = 15, 20 %), cN2a (n = 8, 11 %), or cN2b (n = 26, 34 %) nodal disease. Of these, 32 (42 %) patients underwent a planned neck dissection and 21 (28 %) patients received concomitant chemotherapy. Median follow-up for all patients was 7.1 years (range 0.1–27.2) and 7.8 years (range 2.1–27.2 years) for living patients. The 2- and 5-year control and survival rates were as follows: local control, 98.6 and 96.9 %; local–regional control 95.8 and 92.6 %; cause-specific survival 95.9 and 93.1 %; and overall survival, 92.1 and 83.8 %. One patient failed in the contralateral, non-radiated neck 3 years after primary treatment. Univariate analysis revealed that overall survival was significantly influenced by whether the patient had a primary tumor in the anterior tonsillar pillar versus the tonsillar fossa with the latter performing better. The incidence of severe late complications was 16 %. Ipsilateral RT for patients with squamous cell carcinoma of the anterior tonsillar pillar or tonsillar fossa with no base of tongue or soft palate extension is an efficacious treatment that provides excellent control rates with a relatively low incidence of late complications.
Similar content being viewed by others
References
Mendenhall WM, Amdur RJ, Stringer SP, Villaret DB, Cassisi NJ (2000) Radiation therapy for squamous cell carcinoma of the tonsillar region: a preferred alternative to surgery? J Clin Oncol 18(11):2219–2225
Kuo WR, Wu CC, Lian SL, Ching FY, Lee KW, Juan KH (1993) The effects of radiation therapy on salivary function in patients with head and neck cancer. Gaoxiong Yi Xue Ke Xue Za Zhi 9(7):401–409
Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Malyapa RS, Werning JW, Lansford CD, Villaret DB (2006) Definitive radiotherapy for tonsillar squamous cell carcinoma. Am J Clin Oncol 29(3):290–297. doi:10.1097/01.coc.0000209510.19360.f9
Yeung AR, Liauw SL, Amdur RJ, Mancuso AA, Hinerman RW, Morris CG, Villaret DB, Werning JW, Mendenhall WM (2008) Lymph node-positive head and neck cancer treated with definitive radiotherapy: can treatment response determine the extent of neck dissection? Cancer 112(5):1076–1082. doi:10.1002/cncr.23279
National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 (2010)
Jensen K, Overgaard M, Grau C (2007) Morbidity after ipsilateral radiotherapy for oropharyngeal cancer. Radiother Oncol 85(1):90–97. doi:10.1016/j.radonc.2007.06.005
Koo TR, Wu HG (2013) Long-term results of ipsilateral radiotherapy for tonsil cancer. Radiat Oncol J 31(2):66–71. doi:10.3857/roj.2013.31.2.66
Liu C, Dutu G, Peters LJ, Rischin D, Corry J (2014) Tonsillar cancer: the Peter MacCallum experience with unilateral and bilateral irradiation. Head Neck 36(3):317–322. doi:10.1002/hed.23297
Lynch J, Lal P, Schick U, Nutting CM, Newbold K, Harrington K, Bhide S (2014) Multiple cervical lymph node involvement and extra-capsular extension predict for contralateral nodal recurrence after ipsilateral radiotherapy for squamous cell carcinoma of the tonsil. Oral Oncol 50(9):901–906. doi:10.1016/j.oraloncology.2014.06.019
Jackson SM, Hay JH, Flores AD, Weir L, Wong FL, Schwindt C, Baerg B (1999) Cancer of the tonsil: the results of ipsilateral radiation treatment. Radiother Oncol 51(2):123–128
O’Sullivan B, Warde P, Grice B, Goh C, Payne D, Liu FF, Waldron J, Bayley A, Irish J, Gullane P, Cummings B (2001) The benefits and pitfalls of ipsilateral radiotherapy in carcinoma of the tonsillar region. Int J Radiat Oncol Biol Phys 51(2):332–343
Chronowski GM, Garden AS, Morrison WH, Frank SJ, Schwartz DL, Shah SJ, Beadle BM, Gunn GB, Kupferman ME, Ang KK, Rosenthal DI (2012) Unilateral radiotherapy for the treatment of tonsil cancer. Int J Radiat Oncol Biol Phys 83(1):204–209. doi:10.1016/j.ijrobp.2011.06.1975
Kurita H, Koike T, Narikawa JN, Sakai H, Nakatsuka A, Uehara S, Kobayashi H, Kurashina K (2004) Clinical predictors for contralateral neck lymph node metastasis from unilateral squamous cell carcinoma in the oral cavity. Oral Oncol 40(9):898–903. doi:10.1016/j.oraloncology.2004.04.004
Capote-Moreno A, Naval L, Munoz-Guerra MF, Sastre J, Rodriguez-Campo FJ (2010) Prognostic factors influencing contralateral neck lymph node metastases in oral and oropharyngeal carcinoma. J Oral Maxillofac Surg 68(2):268–275. doi:10.1016/j.joms.2009.09.071
Koo BS, Lim YC, Lee JS, Choi EC (2006) Management of contralateral N0 neck in oral cavity squamous cell carcinoma. Head Neck 28(10):896–901. doi:10.1002/hed.20423
Garden AS, Morrison WH, Wong PF, Tung SS, Rosenthal DI, Dong L, Mason B, Perkins GH, Ang KK (2007) Disease-control rates following intensity-modulated radiation therapy for small primary oropharyngeal carcinoma. Int J Radiat Oncol Biol Phys 67(2):438–444. doi:10.1016/j.ijrobp.2006.08.078
Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tan PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML (2010) Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 363(1):24–35. doi:10.1056/NEJMoa0912217
Kagei K, Shirato H, Nishioka T, Arimoto T, Hashimoto S, Kaneko M, Ohmori K, Honma A, Inuyama Y, Miyasaka K (2000) Ipsilateral irradiation for carcinomas of tonsillar region and soft palate based on computed tomographic simulation. Radiother Oncol 54(2):117–121. doi:S0167-8140(99)00179-6 [pii]
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Kennedy, W.R., Herman, M.P., Deraniyagala, R.L. et al. Ipsilateral radiotherapy for squamous cell carcinoma of the tonsil. Eur Arch Otorhinolaryngol 273, 2151–2156 (2016). https://doi.org/10.1007/s00405-015-3725-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-015-3725-3