Five-year outcomes of squamous cell carcinoma of the tonsil treated with radiotherapy. Am J Clin Oncol 2014 Feb;37(1):57-62
Date
01/30/2013Pubmed ID
23357967DOI
10.1097/COC.0b013e31826b9920Scopus ID
2-s2.0-84893802313 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
PURPOSE: To retrospectively review our single institution experience of patients with tonsillar squamous cell carcinoma.
MATERIAL AND METHODS: Between 1999 and 2005, a total of 79 patients were identified. Stage distribution was as follows: stages I-II, III, IVA, and IVB were in 6, 14, 43, and 16 patients, respectively. Sixty-three patients (80%) were male. Median age was 55.5 years. Treatment generally consisted of external beam radiation therapy (RT) (median dose, 70 Gy), concomitant chemotherapy (CCRT) (cisplatin 100 mg/m on days 1, 22, and 43), and neck dissection (ND), and was administered as follows: stages I/II, 6 patients received RT alone; stages III/IVA, 20, 5, and 32 patients received RT alone, CCRT, and CCRT followed by ND, respectively; stage IVB, 9 and 7 patients received CCRT and CCRT plus ND, respectively.
RESULTS: After a median follow-up of 56 months (range, 12 to 122 mo), the 5-year local control (LC), regional control (RC), distant control (DC), and overall survival (OS) by stage were as follows: stage I-II 100%, 100%, 100%, 100%; stage III-IVA 98%, 96%, 95%, and 88%; stage IVB 100%, 100%, 69%, and 66%, respectively. Among stage IVB patients, DC was significantly lower (P=0.01) and a trend toward lower OS was noted (P=0.08). Long-term percutaneous endoscopic gastrostomy dependence was noted in 3% of them who had received CCRT. The effect of both chemotherapy and ND on treatment outcomes was analyzed; in stage III/IVA patients treated with or without chemotherapy, LC was 97% and 100% (P=0.43); RC was 92% and 100%(P=0.27); and DC was 91% and 94% (P=0.92), respectively. In stage III/IVA, patients treated with CCRT with or without ND, RC was 100% and 88%, respectively (P=0.087).
CONCLUSIONS: Primary radiotherapy with or without CCRT followed by ND provides excellent tumor control with acceptable toxicity in treating squamous cell carcinoma of the tonsil.
Author List
Mourad WF, Hu KS, Puckett L, Hauerstock D, Shourbaji RA, Li Z, Manolidis S, Schantz S, Tran T, Jacobson A, Urken M, Culliney B, Persky M, Harrison LBAuthor
Lindsay L. Puckett MD Assistant Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Antineoplastic Combined Chemotherapy Protocols
Carcinoma, Squamous Cell
Chemoradiotherapy
Disease-Free Survival
Female
Follow-Up Studies
Gastrostomy
Humans
Kaplan-Meier Estimate
Middle Aged
Neck Dissection
Neoplasm Staging
Positron-Emission Tomography
Retrospective Studies
Tonsillar Neoplasms
Treatment Outcome