Risk of contralateral nodal failure following ipsilateral IMRT for node-positive tonsillar cancer

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Abstract

Purpose To determine the risk of contralateral nodal failure following ipsilateral radiotherapy in a series of patients with node-positive tonsillar squamous cell carcinoma. Methods Retrospective review was used to identify 34 patients with well-lateralized node-positive tonsillar squamous cell carcinoma treated with definitive or adjuvant radiation to the primary site and ipsilateral neck between 2005 and 2015. Contralateral nodal failure, locoregional recurrence, distant metastasis, and overall survival were calculated using actuarial and/or cumulative incidence statistics. Results At last follow-up, contralateral nodal failure was only observed in 1 patient (3%) with N1 disease. At median follow-up of 34 months for surviving patients, the 3-year overall survival probability was 87%, and the 3 year cumulative incidences of locoregional failure and distant metastasis were 6.5% and 7.2%, respectively. No disease-free patient was permanently gastrostomy-dependent. Conclusion Ipsilateral radiation treatment with IMRT is effective in node-positive patients with well-lateralized tonsillar cancer, resulting in a low risk of contralateral regional recurrence, even in patients with N2b disease.

Original languageEnglish (US)
Pages (from-to)35-38
Number of pages4
JournalOral Oncology
Volume75
DOIs
StatePublished - Dec 1 2017

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Tonsillar Neoplasms
Squamous Cell Carcinoma
Radiation
Neoplasm Metastasis
Recurrence
Gastrostomy
Survival
Incidence
Neck
Radiotherapy

Keywords

  • IMRT
  • Ipsilateral radiotherapy
  • Radiotherapy
  • Regional recurrence
  • Tonsillar cancer

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

Cite this

@article{5e35db56a80d4e4d8146eed82593fe35,
title = "Risk of contralateral nodal failure following ipsilateral IMRT for node-positive tonsillar cancer",
abstract = "Purpose To determine the risk of contralateral nodal failure following ipsilateral radiotherapy in a series of patients with node-positive tonsillar squamous cell carcinoma. Methods Retrospective review was used to identify 34 patients with well-lateralized node-positive tonsillar squamous cell carcinoma treated with definitive or adjuvant radiation to the primary site and ipsilateral neck between 2005 and 2015. Contralateral nodal failure, locoregional recurrence, distant metastasis, and overall survival were calculated using actuarial and/or cumulative incidence statistics. Results At last follow-up, contralateral nodal failure was only observed in 1 patient (3{\%}) with N1 disease. At median follow-up of 34 months for surviving patients, the 3-year overall survival probability was 87{\%}, and the 3 year cumulative incidences of locoregional failure and distant metastasis were 6.5{\%} and 7.2{\%}, respectively. No disease-free patient was permanently gastrostomy-dependent. Conclusion Ipsilateral radiation treatment with IMRT is effective in node-positive patients with well-lateralized tonsillar cancer, resulting in a low risk of contralateral regional recurrence, even in patients with N2b disease.",
keywords = "IMRT, Ipsilateral radiotherapy, Radiotherapy, Regional recurrence, Tonsillar cancer",
author = "Sujana Gottumukkala and Pham, {Nhat Long} and Baran Sumer and Larry Myers and John Truelson and Lucien Nedzi and Saad Khan and Randy Hughes and Sher, {David J.}",
year = "2017",
month = "12",
day = "1",
doi = "10.1016/j.oraloncology.2017.10.010",
language = "English (US)",
volume = "75",
pages = "35--38",
journal = "Oral Oncology",
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T1 - Risk of contralateral nodal failure following ipsilateral IMRT for node-positive tonsillar cancer

AU - Gottumukkala, Sujana

AU - Pham, Nhat Long

AU - Sumer, Baran

AU - Myers, Larry

AU - Truelson, John

AU - Nedzi, Lucien

AU - Khan, Saad

AU - Hughes, Randy

AU - Sher, David J.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Purpose To determine the risk of contralateral nodal failure following ipsilateral radiotherapy in a series of patients with node-positive tonsillar squamous cell carcinoma. Methods Retrospective review was used to identify 34 patients with well-lateralized node-positive tonsillar squamous cell carcinoma treated with definitive or adjuvant radiation to the primary site and ipsilateral neck between 2005 and 2015. Contralateral nodal failure, locoregional recurrence, distant metastasis, and overall survival were calculated using actuarial and/or cumulative incidence statistics. Results At last follow-up, contralateral nodal failure was only observed in 1 patient (3%) with N1 disease. At median follow-up of 34 months for surviving patients, the 3-year overall survival probability was 87%, and the 3 year cumulative incidences of locoregional failure and distant metastasis were 6.5% and 7.2%, respectively. No disease-free patient was permanently gastrostomy-dependent. Conclusion Ipsilateral radiation treatment with IMRT is effective in node-positive patients with well-lateralized tonsillar cancer, resulting in a low risk of contralateral regional recurrence, even in patients with N2b disease.

AB - Purpose To determine the risk of contralateral nodal failure following ipsilateral radiotherapy in a series of patients with node-positive tonsillar squamous cell carcinoma. Methods Retrospective review was used to identify 34 patients with well-lateralized node-positive tonsillar squamous cell carcinoma treated with definitive or adjuvant radiation to the primary site and ipsilateral neck between 2005 and 2015. Contralateral nodal failure, locoregional recurrence, distant metastasis, and overall survival were calculated using actuarial and/or cumulative incidence statistics. Results At last follow-up, contralateral nodal failure was only observed in 1 patient (3%) with N1 disease. At median follow-up of 34 months for surviving patients, the 3-year overall survival probability was 87%, and the 3 year cumulative incidences of locoregional failure and distant metastasis were 6.5% and 7.2%, respectively. No disease-free patient was permanently gastrostomy-dependent. Conclusion Ipsilateral radiation treatment with IMRT is effective in node-positive patients with well-lateralized tonsillar cancer, resulting in a low risk of contralateral regional recurrence, even in patients with N2b disease.

KW - IMRT

KW - Ipsilateral radiotherapy

KW - Radiotherapy

KW - Regional recurrence

KW - Tonsillar cancer

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