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Cancer. 2017 Dec 1;123(23):4594-4607. doi: 10.1002/cncr.30931. Epub 2017 Sep 7.

Comparison of unilateral versus bilateral intensity-modulated radiotherapy for surgically treated squamous cell carcinoma of the palatine tonsil.

Author information

1
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.
2
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
3
Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
4
Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
5
Division of Head and Neck Surgery, Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri.
6
Head and Neck Surgery, Florida Hospital Celebration Health, Celebration, Florida.
7
Division of Hematology and Oncology, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
8
Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee.

Abstract

BACKGROUND:

The authors hypothesized that unilateral intensity-modulated radiotherapy (IMRT) would decrease toxicity compared with bilateral IMRT for patients with lateralized palatine tonsillar cancer and a neck classification of N0 to N2b, with similar oncological outcomes.

METHODS:

A total of 154 patients were treated with postoperative IMRT from 1997 through 2013. Data were collected prospectively from 2005 to 2013 and retrospectively collected before 2005. Of those patients with lateralized primary and N0 to N2b disease, 48 received unilateral IMRT (group 1) and 59 received bilateral IMRT (group 2); a total of 47 patients had nonlateralized primary or N2c to N3 disease and received bilateral IMRT (group 3).

RESULTS:

The median follow-up was 5.5 years. The 5-year locoregional control rates were similar in group 1, group 2, and group 3 (100%, 96%, and 94%, respectively; pooled comparison: P = .39 and group 1 vs group 2 comparison: P = .19). The 5-year overall survival rates were similar in group 1, group 2, and group 3 (85%, 79%, and 76%, respectively; pooled comparison: P = .60 and group 1 vs group 2 comparison: P = .25). There were no contralateral neck recurrences noted among unilaterally treated patients. Unilateral IMRT reduced acute toxicity and improved patient-reported quality of life compared with bilateral IMRT.

CONCLUSIONS:

Unilateral IMRT appears to reduce acute toxicity and achieves oncological outcomes similar to those of bilateral IMRT in selected patients with lateralized palatine tonsillar cancer with a neck classification of N0 to N2b. Cancer 2017;123:4594-4607. © 2017 American Cancer Society.

KEYWORDS:

head and neck; intensity-modulated radiotherapy (IMRT); oropharynx; quality of life; squamous cell carcinoma; tonsillar cancer; unilateral radiation

PMID:
28881377
DOI:
10.1002/cncr.30931
[Indexed for MEDLINE]

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