Management of cervical metastases in advanced squamous cell carcinoma of the tonsillar fossa following radiotherapy.
OBJECTIVE
To assess the value of planned neck dissection in patients with a complete response to definitive radiotherapy for squamous cell carcinoma of the tonsillar fossa with advanced nodal disease.


METHODS
Case series.


METHODS
Academic tertiary care medical center.


METHODS
A consecutive series of 36 patients with squamous cell carcinoma of the tonsillar fossa with N2 or N3 nodal disease treated with primary radiation therapy with or without concurrent chemotherapy between January 1, 1992, and April 1, 2003, at the University of California, San Francisco, Comprehensive Cancer Center. Patients treated with primary surgery, those treated with palliative intent, or those with preexisting malignancies were excluded.


METHODS
Regional control and overall survival.


RESULTS
Of the study group, 15 patients (42%) achieved a complete response, 17 (47%) achieved a partial response, and 1 (3%) was a nonresponder. The response in 3 patients (8%) could not be assessed. Of the 15 patients with a complete response, only 2 (13%) later developed regional recurrences, 1 of which was an isolated recurrence in the neck. Regional control and overall survival at 3 years were 78% and 48%, respectively.


CONCLUSIONS
The rate of regional recurrence after a complete response to radiation therapy with or without concurrent chemotherapy for tonsillar squamous cell carcinoma with advanced cervical metastases is low. Our results support close surveillance of the neck in those who have achieved a complete response after radiation therapy with or without chemotherapy.
Mau
Ted
T
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco 94143-0342, USA.
Oh
Young
Y
Bucci
M Kara
MK
Eisele
David W
DW
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate; D014067:Tonsillar Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D016896:Treatment Outcome