Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 1;45(10):422-426.
doi: 10.1097/COC.0000000000000940. Epub 2022 Sep 9.

Long-term Locoregional Control With Unilateral Radiation for AJCC-7 T1-2N2b Tonsillar Cancer

Andrew J Frankart  1 , Chike O Abana  2 , Natalie Geier  1 , Houda Bahig  3 , Gohar Shahwar Manzar  2 , Adam S Garden  2 , Jack Phan  2 , Vinita Takiar  1   4
Affiliations

Long-term Locoregional Control With Unilateral Radiation for AJCC-7 T1-2N2b Tonsillar Cancer

Andrew J Frankart et al. Am J Clin Oncol. .

Abstract

Objectives: Unilateral radiation to cervical nodes has been used as a de-escalation strategy in well-lateralized tonsil cancers. The efficacy of this approach with multiple ipsilateral nodes is not established. The study hypothesis was that unilateral radiation for American Joint Committee on Cancer (AJCC)-7 T1-2N2b tonsillar cancer results in a low rate of contralateral nodal failure.

Materials and methods: This study was a retrospective chart review of patients with AJCC-7 T1-2N2b tonsillar cancer from 2 academic institutions who were treated with unilateral radiation. The primary endpoint was the contralateral nodal failure rate. Locoregional control, overall survival, and the need for gastrostomy tube placement were additional endpoints.

Results: The study cohort included 66 patients treated between 2005 and 2016. The median follow-up time was 80.9 months; contralateral nodal failure occurred in 2/66 (3.0%) patients at 4.1 and 20.9 months, respectively. Both patients underwent salvage treatment with long-term subsequent survival. Overall locoregional control at both 2 and 5 years was 93.9% and the median duration of control was not reached. Overall survival at 5 years was 92.4%.

Conclusions: The use of unilateral radiation for AJCC-7 T1-2N2b tonsillar cancer resulted in low rates of contralateral nodal failure. This outcome demonstrates the safety of considering unilateral radiation treatment in patients with a relatively high ipsilateral nodal burden.

PubMed Disclaimer

Conflict of interest statement

A.F. was supported by the ASTRO-AstraZeneca Radiation Oncology Research Training Fellowship. V.T. was supported in part by Career Development Award IK2 BX004360 from the United States Department of Veterans Affairs Biomedical Laboratory Research and Development Service and the Dr. Bernard S. Aron Fund. The remaining authors declare no conflicts of interest.

References

    1. Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Oral Cavity and Pharynx Cancer ; Bethesda, MD, 2021.
    1. National Comprehensive Cancer Network. Head and Neck Cancers ; Plymouth Meeting, PA, 2021.
    1. Tota JE, Best AF, Zumsteg ZS, et al. Evolution of the oropharynx cancer epidemic in the united states: moderation of increasing incidence in younger individuals and shift in the burden to older individuals. J Clin Oncol. 2019;37:1538–1546.
    1. Chen L, Riaz N, Lee N, et al. Current considerations for radiotherapy in HPV‐associated head and neck cancer. J Surg Oncol. 2021;124:945–951.
    1. Tsai CJ, McBride SM, Riaz N, et al. Evaluation of substantial reduction in elective radiotherapy dose and field in patients with human papillomavirus–associated oropharyngeal carcinoma treated with definitive chemoradiotherapy. JAMA Oncol. 2022;8:364–372.

LinkOut - more resources