Departments of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Departments of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
Int J Radiat Oncol Biol Phys. 2022 Aug 1;113(5):1054-1062. doi: 10.1016/j.ijrobp.2022.04.035. Epub 2022 May 2.
The goal of this study was to evaluate disease, survival, and toxic effects after unilateral radiation therapy treatment for tonsillar cancer.
A retrospective study was performed of patients treated at our institution within the period from 2000 to 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.
The cohort comprised 403 patients, including 343 (85%) with clinical and/or radiographic evidence of ipsilateral cervical nodal disease and 181 (45%) with multiple involved nodes. Human papillomavirus 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%) patients. Five- and 10-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.
For patients with well-lateralized tonsillar tumors and no clinically evident adenopathy of the contralateral neck, unilateral radiation therapy offers favorable rates of disease outcomes and a relatively low toxicity profile.
本研究旨在评估扁桃体癌单侧放疗治疗后的疾病、生存和毒副作用。
对 2000 年至 2018 年期间在我院接受治疗的患者进行回顾性研究。通过患者特征和治疗方法的汇总统计来评估队列。采用 Kaplan-Meier 法评估生存结果。
队列包括 403 名患者，其中 343 名（85%）有同侧颈部淋巴结疾病的临床和/或影像学证据，181 名（45%）有多个受累淋巴结。294 例（73%）肿瘤中检测到人乳头瘤病毒。中位随访时间为 5.8 年。疾病复发罕见，9 例（2%）患者出现局部复发，13 例（3%）患者出现颈部复发，9 例（2%）患者出现未照射对侧颈部复发。5 年和 10 年总生存率分别为 94%和 89%。32 例（9%）患者需要胃造口管，治疗后 6 个月无患者需要进食管。
对于肿瘤位于扁桃体一侧、对侧颈部无明显淋巴结转移的患者，单侧放疗可获得良好的疾病结局，并具有相对较低的毒性特征。
