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Comparison of the Clinical Outcomes of Patients with Squamous Cell Carcinoma of the Tonsil Receiving Postoperative Ipsilateral Versus Bilateral Neck Radiotherapy: A Propensity Score Matching Analysis (KROG 11-07)

 Youngkyong Kim  ;  Kwan Ho Cho  ;  Sung Ho Moon  ;  Chang Geol Lee  ;  Ki Chang Keum  ;  Sang-Wook Lee  ;  Yong Chan Ahn  ;  Dongryul Oh  ;  Yeon-Sil Kim  ;  Yong Kyun Won  ;  Hong-Gyun Wu  ;  J Hun Hah  ;  Young-Taek Oh 
 CANCER RESEARCH AND TREATMENT, Vol.49(4) : 1097-1105, 2017-10 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell / diagnosis ; Carcinoma, Squamous Cell / mortality ; Carcinoma, Squamous Cell / radiotherapy* ; Carcinoma, Squamous Cell / surgery ; Combined Modality Therapy / adverse effects ; Combined Modality Therapy / methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Postoperative Care* ; Propensity Score ; Radiotherapy, Adjuvant ; Survival Analysis ; Tonsillar Neoplasms / diagnosis ; Tonsillar Neoplasms / mortality ; Tonsillar Neoplasms / radiotherapy* ; Tonsillar Neoplasms / surgery ; Tonsillectomy ; Treatment Failure ; Treatment Outcome
Adjuvant radiotherapy ; Ipsilateral neck ; Radiation volume ; Tonsillar neoplasms ; Toxicity
Purpose: The impact of postoperative ipsilateral neck radiotherapy (INRT) versus bilateral neck radiotherapy (BNRT) on the clinical outcomes of patients with tonsillar squamous cell carcinoma was analyzed retrospectively. Materials and methods: Between October 2001 and June 2012, 241 patients with T1-2 and N0-N2b tonsillar carcinoma from 16 institutes underwent postoperative INRT (n=84) or BNRT (n=157) following a tonsillectomy. Seventy patients were identified from each group by propensity score matching and compared in terms of the overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates calculated using the Kaplan-Meier method with a log-rank test. Results: The median follow-up was 55 months (range, 3 to 133 months). The survival outcomes in the INRT and BNRT groups were similar: 5-year OS (92.8% vs. 94.0%, p=0.985), DFS (80.5% vs. 94.2%. p=0.085), LRRFS (88.1% vs. 97.1%, p=0.083), and DMFS (92.7% vs. 97.0%, p=0.370). Subgroup analysis revealed no contralateral neck recurrence in 61 patients with T1-2N0-2a regardless of the treatment groups. For 79 patients with N2b, contralateral neck recurrence was more common in the INRT group than in the BNRT group (7.9% vs. 0.0%), but the difference was not significant (p=0.107). The overall grade ≥ 2 toxicities were lower in the INRT group: acute (45.7% vs. 74.3%, p=0.001) and late (4.3% vs. 31.4%, p < 0.001), respectively. Conclusion: INRT is an attractive strategy for patients with T1-2N0-2a tonsillar carcinoma compared to BNRT. For patients with N2b, there was a small risk of contralateral neck recurrence when treated with INRT, but its impact on the OS was limited with successful salvage treatment.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
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