Unilateral Radiotherapy for Tonsillar Cancer: Treatment Outcomes in the Era of Human Papilloma Virus (HPV), Positron-emission Tomography (PET) and Intensity-modulated Radiation Therapy (IMRT)
Menée sur la période 2000-2018 auprès de 403 patients atteints d'un cancer de l'amygdale (durée médiane de suivi : 5,8 ans), cette étude analyse l'efficacité, du point de vue de la survie et de la récidive, et la toxicité d'un traitement par radiothérapie unilatérale
Purpose: The goal of this study was to evaluate disease, survival, and toxicity outcomes following unilateral radiotherapy treatment for tonsillar cancer. Methods: A retrospective study was performed of patients treated at our institution between 2000-2018. Summary statistics were used to assess the cohort by patient characteristics and treatments delivered. The Kaplan-Meier method was used to determine survival outcomes. Results: The cohort constituted 403 patients, including 343 (85%) with clinical and/or radiographic evidence of ipsilateral cervical nodal disease including 181 (45%) with multiple involved nodes. HPV was detected in 294 (73%) tumors. Median follow-up time was 5.8 years. Disease relapse was infrequent−with local recurrence in 9 (2%) patients, neck recurrence in 13 (3%) patients, and recurrence in the unirradiated contralateral neck in 9 (2%) of patients. Five- and ten-year overall survival rates were 94% and 89%, respectively. Gastrostomy tubes were needed in 32 (9%) patients, and no patient had a feeding tube 6 months after therapy. Conclusion: For patients with well lateralized tonsillar tumors and no clinically evident adenopathy of the contralateral neck, unilateral radiotherapy offers favorable rates of disease outcomes and a relatively low toxicity profile.
International Journal of Radiation Oncology, Biology, Physics 2022