title: Ipsilateral radiotherapy for squamous cell carcinoma of the tonsil.
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.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Kennedy
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Herman
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: Rohan L
authors.initials: RL
authors.lastname: Deraniyagala
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Amdur
authors.affiliation: Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Werning
authors.affiliation: Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Dziegielewski
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, 2000 SW Archer Road, PO Box 100385, Gainesville, FL, 32610-0385, USA. mendwm@shands.ufl.edu.
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000706:statistics & numerical data; D009367:Neoplasm Staging; D010160:Palate, Soft / Q000473:pathology; D014066:Palatine Tonsil; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014059:Tongue / Q000473:pathology; D014067:Tonsillar Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome
keywords: Head and neck; Ipsilateral radiotherapy, tonsil, oropharynx; Outcomes