Skip Navigation LinksHome > February 2014 - Volume 37 - Issue 1 > Five-Year Outcomes of Squamous Cell Carcinoma of the Tonsil...
American Journal of Clinical Oncology:
doi: 10.1097/COC.0b013e31826b9920
Original Articles: Head & Neck

Five-Year Outcomes of Squamous Cell Carcinoma of the Tonsil Treated With Radiotherapy

Mourad, Waleed F. MD, MSc, PhD*; Hu, Kenneth S. MD*; Puckett, Lindsay MD*; Hauerstock, David MD*; Shourbaji, Rania A. MPH*; Li, Zujun MD; Manolidis, Spiros MD; Schantz, Stimson MD; Tran, Theresa MD; Jacobson, Adam MD; Urken, Mark MD; Culliney, Bruce MD; Persky, Mark MD; Harrison, Louis B. MD*

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Purpose: To retrospectively review our single institution experience of patients with tonsillar squamous cell carcinoma.

Material and Methods: Between 1999 and 2005, a total of 79 patients were identified. Stage distribution was as follows: stages I-II, III, IVA, and IVB were in 6, 14, 43, and 16 patients, respectively. Sixty-three patients (80%) were male. Median age was 55.5 years. Treatment generally consisted of external beam radiation therapy (RT) (median dose, 70 Gy), concomitant chemotherapy (CCRT) (cisplatin 100 mg/m2 on days 1, 22, and 43), and neck dissection (ND), and was administered as follows: stages I/II, 6 patients received RT alone; stages III/IVA, 20, 5, and 32 patients received RT alone, CCRT, and CCRT followed by ND, respectively; stage IVB, 9 and 7 patients received CCRT and CCRT plus ND, respectively.

Results: After a median follow-up of 56 months (range, 12 to 122 mo), the 5-year local control (LC), regional control (RC), distant control (DC), and overall survival (OS) by stage were as follows: stage I-II 100%, 100%, 100%, 100%; stage III-IVA 98%, 96%, 95%, and 88%; stage IVB 100%, 100%, 69%, and 66%, respectively. Among stage IVB patients, DC was significantly lower (P=0.01) and a trend toward lower OS was noted (P=0.08). Long-term percutaneous endoscopic gastrostomy dependence was noted in 3% of them who had received CCRT. The effect of both chemotherapy and ND on treatment outcomes was analyzed; in stage III/IVA patients treated with or without chemotherapy, LC was 97% and 100% (P=0.43); RC was 92% and 100%(P=0.27); and DC was 91% and 94% (P=0.92), respectively. In stage III/IVA, patients treated with CCRT with or without ND, RC was 100% and 88%, respectively (P=0.087).

Conclusions: Primary radiotherapy with or without CCRT followed by ND provides excellent tumor control with acceptable toxicity in treating squamous cell carcinoma of the tonsil.

© 2014 by Lippincott Williams & Wilkins, Inc


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