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. 2017 Aug 30;17(1):598.
doi: 10.1186/s12885-017-3571-3.

Chemoradiotherapy versus surgery followed by postoperative radiotherapy in tonsil cancer: Korean Radiation Oncology Group (KROG) study

Sanghyuk Song  1 , Hong-Gyun Wu  2 , Chang Geol Lee  3 , Ki Chang Keum  3 , Mi Sun Kim  3 , Yong Chan Ahn  4 , Dongryul Oh  4 , Hyo Jung Park  4 , Sang-Wook Lee  5 , Geumju Park  5 , Sung Ho Moon  6 , Kwan Ho Cho  6 , Yeon-Sil Kim  7 , Yongkyun Won  7 , Young-Taek Oh  8 , Won-Taek Kim  9 , Jae-Uk Jeong  10
Affiliations

Chemoradiotherapy versus surgery followed by postoperative radiotherapy in tonsil cancer: Korean Radiation Oncology Group (KROG) study

Sanghyuk Song et al. BMC Cancer. .

Abstract

Background: Treatment of tonsil cancer, a subset of oropahryngeal cancer, varies between surgery and radiotherapy. Well-designed studies in tonsil cancer have been rare and it is still controversial which treatment is optimal. This study aimed to assess the outcome and failure patterns in tonsil cancer patients treated with either approaches.

Methods: We retrospectively reviewed medical records of 586 patients with tonsil cancer, treated between 1998 and 2010 at 16 hospitals in Korea. Two hundred and one patients received radiotherapy and chemotherapy (CRT), while 385 patients received surgery followed by radiotherapy and/or chemotherapy (SRT). Compared with the SRT group, patients receiving CRT were older, with more advanced T stage and received higher radiotherapy dose given by intensity modulation techniques. Overall survival (OS), disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and clinicopathologic factors were analyzed.

Results: At follow-up, the 5-year OS, DFS, LRRFS and DMFS rates in the CRT group were 82, 78, 89, and 94%, respectively, and in the SRT group were 81, 73, 87, and 89%, respectively. Old age, current smoking, poor performance status, advanced T stage, nodal involvement, and induction chemotherapy were associated with poor OS. Induction chemotherapy had a negative prognostic impact on OS in both treatment groups (p = 0.001 and p = 0.033 in the CRT and SRT groups, respectively).

Conclusions: In our multicenter, retrospective study of tonsil cancer patients, the combined use of radiotherapy and chemotherapy resulted in comparable oncologic outcome to surgery followed by postoperative radiotherapy, despite higher-risk patients having been treated with the definitive radiotherapy. Induction chemotherapy approaches combined with either surgery or definitive radiotherapy were associated with unfavorable outcomes.

Keywords: Adjuvant radiotherapy; Chemoradiotherapy; Induction chemotherapy; Surgery; Tonsil cancer.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was reviewed and approved by the Institutional Review Boards of all participating hospitals, and adhered to the tenets of the Declaration of Helsinki. Owing to retrospective approach of this study, the need for informed consent was waived by the ethics committees. Additional information about the ethics committees and waiver of informed consent is provided in Additional file 1.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overall survival, disease-free survival, locoregional recurrence-free survival, and distant metastasis-free survival according to treatment group
Fig. 2
Fig. 2
Overall survival according to presence or absence of induction chemotherapy in each treatment group
See this image and copyright information in PMC

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