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).
- Author:
Youngkyong KIM
1
;
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
Author Information
- Publication Type:Journal Article
- Keywords: Ipsilateral neck; Adjuvant radiotherapy; Tonsillar neoplasms; Radiation volume; Toxicity
- MeSH: Academies and Institutes; Carcinoma, Squamous Cell*; Disease-Free Survival; Epithelial Cells*; Follow-Up Studies; Humans; Methods; Neck*; Palatine Tonsil*; Propensity Score*; Radiotherapy*; Radiotherapy, Adjuvant; Recurrence; Retrospective Studies; Salvage Therapy; Tonsillar Neoplasms; Tonsillectomy
- From:Cancer Research and Treatment 2017;49(4):1097-1105
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
