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

Re I. Chin, Yuan James Rao, Michael Y. Hwang, Christopher R. Spencer, Michael Pierro, Todd DeWees, Pranav Patel, Parul Sinha, Hiram A. Gay, Mackenzie Daly, Bruce H. Haughey, Brian Nussenbaum, Douglas R. Adkins, James S. Lewis, Wade L. Thorstad

Research output: Contribution to journalArticle

14 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)4594-4607
Number of pages14
JournalCancer
Volume123
Issue number23
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Chin, R. I., Rao, Y. J., Hwang, M. Y., Spencer, C. R., Pierro, M., DeWees, T., Patel, P., Sinha, P., Gay, H. A., Daly, M., Haughey, B. H., Nussenbaum, B., Adkins, D. R., Lewis, J. S., & Thorstad, W. L. (2017). Comparison of unilateral versus bilateral intensity-modulated radiotherapy for surgically treated squamous cell carcinoma of the palatine tonsil. Cancer, 123(23), 4594-4607. https://doi.org/10.1002/cncr.30931