Definitive Radiotherapy versus Postoperative Radiotherapy for Tonsil Cancer.
OBJECTIVE
The purpose of this study is to analyze treatment outcome of radiotherapy (RT) in patients with stage III-IV tonsil cancer managed by surgery followed by postoperative RT (SRT) and definitive chemoradiotherapy (CRT), and to thereby evaluate the most feasible treatment modality.


METHODS
Of 124 patients, 67 underwent CRT, and 57 underwent SRT. We compared survival and complication rates in both groups.


RESULTS
The median follow-up time was 57 months (range, 19 to 255 months) for surviving patients. At five years, locoregional progression-free survival (LRPFS) and overall survival (OS) were 88% and 80%, respectively. No significant difference in LRPFS (p=0.491) and OS (p=0.177) was observed between CRT and SRT. In multivariate analysis, old age and higher T stage showed a significant association with poor LRPFS, PFS, and OS; higher N stage showed an association with poor PFS and a trend of poor LRPFS, while no association with OS was observed; treatment modality (CRT and SRT) showed no association with LRFPS, PFS, and OS. Grade 3 or higher mucositis was observed in 12 patients (21%) in the SRT group, and 25 patients (37%) in the CRT group.


CONCLUSIONS
Definitive CRT and SRT have similar treatment outcomes for patients with stage III-IV tonsil cancer. Although acute complication rate appears to be higher in the CRT group, it should be noted that not all data on complications were included in this retrospective study. To determine the most feasible treatment modality, not only mucositis and xerostomia, but also emotional aspect and quality of life, should be considered.
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
Tae Ryool
TR
Koo
Hong-Gyun
HG
Wu
J Hun
JH
Hah
Myung-Whun
MW
Sung
Kwang-Hyun
KH
Kim
Bhumsuk
B
Keam
Tae Min
TM
Kim
Se-Hoon
SH
Lee
Dong-Wan
DW
Kim
Dae-Seog
DS
Heo
Charn Il
CI
Park
Chemoradiotherapy; Intensity-modulated radiotherapy; Tonsil neoplasms