OBJECTIVE: To investigate the clinical features and prognostic factors of primary tonsil lymphoma (PTL). METHODS: The clinical data of 41 patients diagnosed with PTL and treated in the Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2022 were collected and retrospectively analyzed. Their clinical features and prognostic factors were analyzed. RESULTS: All the 41 patients were newly diagnosed with PTL, and the median age of onset was 58(19-85) years. Among them, 19 patients started with pharyngeal pain, 12 patients presented with dysphagia, 8 patients presented with pharyngeal mass, and 2 patients presented with blurred articulation. The most common pathological type was diffuse large B-cell lymphoma (24 cases, 58.54%). All patients received chemotherapy, and 3 patients were combined with hematopoietic stem cell transplantation. Among 41 patients, 11 (26.83%) achieved complete response, 14 (34.15%) achieved partial response, and the total response rate was 60.98% (25/41). The median follow-up time was 37(6-107) months, the 5-year overall survival (OS) rate was 70.81% and 5-year progression-free survival (PFS) rate was 66.20%. Univariate analysis showed that B symptoms, Ki-67, β₂-MG and IPI score had significant effects on PFS and OS of patients (all P < 0.05). Multivariate analysis showed that IPI score was an independent risk factor for PFS and OS of patients (P < 0.05). CONCLUSION The clinical manifestations of PTL lack specificity, and the prognosis is relatively good. Most patients can achieve long-term survival after treatment. IPI score is related to the prognosis.
Tonsillar Neoplasms/pathology* ; Lymphoma/pathology* ; Humans ; Prognosis ; Retrospective Studies ; Drug Therapy ; Progression-Free Survival ; Male ; Female ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Lymphoma, B-Cell/pathology* ; Survival Rate

Objective: Using propensity score matching method(PSM) to investigate the clinical effect of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma. Methods: A retrospective analysis was conducted on the clinical data of 324 patients diagnosed with advanced tonsillar squamous cell carcinoma and treated in Peking Union Medical College Hospital from 2000 to 2018, confirmed by pathology and without distant metastasis. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching(PSM). Results: Of the 324 patients, 102 were treated with non-surgery chemoradiotherapy treatment strategies and 222 with surgical plus radio(chemo)therapy treatment. Cox multivariate analysis showed that the non-surgery treatment group had a favorable prognosis than the surgical treatment group, however, these outcomes were not significantly different [overall survival(OS): adjusted Hazard Ratios(aHR): 0.92, 95% confidence interval(CI): 0.60-1.42; disease-specific survival(DSS): aHR: 0.71, 95%CI: 0.43-1.20; disease-free survival(DFS): aHR: 0.82, 95%CI: 0.53-1.28]. The new patient cohort consisted of 102 subpairs after PSM. There were no significant differences between two groups(OS: aHR: 0.85, 95%CI: 0.51-1.40; DSS: aHR: 0.62, 95%CI: 0.35-1.11; DFS: aHR: 0.80, 95%CI: 0.49-1.33). Conclusion: Our findings indicate that patients with non-surgical treatment do not have significantly better survival outcomes compared to surgical treatment group, while non-surgical treatment has advantages in improving the quality of life of patients, so comprehensive treatment based on radiotherapy and chemotherapy may be recommended for advanced tonsillar squamous cell carcinoma.
Carcinoma, Squamous Cell/therapy* ; Chemoradiotherapy ; Humans ; Quality of Life ; Retrospective Studies ; Tonsillar Neoplasms/therapy*

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.
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

This paper reports a case of recurrence of tonsillar cancer on the right 6 months after radiotherapy with pharyngeal hemorrhage for 4 days and aggravation in the next day. The pharyngeal hemorrhage was severe in the case and the maximum of single amount of bleeding was approximately 200 ml. The examination showed active bleeding on the ulcer with a diameter of 2 cm in the right tonsil and the depth of 1 cm. After repeated compression hemostasis proved to be invalid, selective embolization was applied on the patient and the symtoms of pharyngeal hemorrhage disappeared without complications. The patient was discharged after 2 weeks of observation without any recurrence of hemorrhage.
Embolization, Therapeutic ; methods ; Hemorrhage ; etiology ; therapy ; Hemostasis ; Humans ; Neoplasm Recurrence, Local ; Palatine Tonsil ; Pharyngeal Diseases ; etiology ; therapy ; Recurrence ; Tonsillar Neoplasms ; complications

Acupuncture Therapy ; Aged ; Female ; Humans ; Radiotherapy ; adverse effects ; Tonsillar Neoplasms ; radiotherapy ; Xerostomia ; etiology ; therapy

Recurrent syncope as a complication of recurrent neck malignancy is an uncommon but well documented association. The syncope is presumed to occur when a tumor mass invades the baroreceptor within the carotid sinus or when it disrupts the afferent nerve fibers of the glossopharyngeal nerve. A 59-year-old man presented with recurrent syncope and headache. He had a wide local excision including tonsillectomy and modified left radical neck dissection for tonsilar cancer 4 years ago. A computed tomography scan revealed ill-defined lesions in left parapharyngeal, carotid space and right upper jugular region. After clinical evaluation, cardiac pacemaker was placed, but he still suffered from the syncope. Then, he received the chemotherapy with docetaxel and cisplatin. The last hypotension event occurred on day 10 of the chemotherapy. Six months after 3 cycles of chemotherapy, he remained in complete remission and resolution of syncope. We report a case in which syncope was associated with a recurrence of tonsilar cancer and successfully treated with chemotherapy.
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Squamous Cell/*complications/drug therapy/radiography ; Cisplatin/*therapeutic use ; Head and Neck Neoplasms/*complications/drug therapy/radiography ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*complications/drug therapy ; *Pacemaker, Artificial ; Syncope/*drug therapy/etiology ; Taxoids/*therapeutic use ; Tonsillar Neoplasms/*complications/drug therapy/radiography

OBJECTIVETo explore a better approach to resect the advanced oropharyngeal carcinoma.

METHODSFrom 1995 to 2005, 17 patients underwent mandibular swing procedure for excision of advanced oropharyngeal carcinoma including: 13 tonsillar cancers, 2 soft palate carcinomas and 2 lingual root cancers. Surgical procedure was selected according to the lesion. All tumors were resected through the mandibular swing approach or its combined approaches. Immediate reconstruction of the surgical defect was done using tongue flap, pectoralis major myocutaneous flap, sternohyoid myofascial flap, temporalis myofascial flap and forehead flap, respectively. After surgical resection of the tumors, all patients received postoperative radiotherapy.

RESULTSAll patients' advanced oropharyngeal carcinoma were successfully resected as planned through the mandibular swing procedure or its combined procedures without severe complications. Functions of deglutition, respiration and speech were well restored. The 3- and 5-year survival rate was 54. 5% and 40%, respectively.

CONCLUSIONThe mandibular swing procedure and its combined approach is safe and effective in the surgical resection of the advanced oropharyngeal carcinoma, which can provide a good exposure for the oropharynx, supraglottic region, hypopharynx, the parapharyngeal space and the base of the skull.

Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Humans ; Male ; Mandible ; radiation effects ; surgery ; Middle Aged ; Neoplasm Staging ; Oropharyngeal Neoplasms ; pathology ; radiotherapy ; surgery ; Postoperative Period ; Radiotherapy, Adjuvant ; Survival Analysis ; Tonsillar Neoplasms ; pathology ; radiotherapy ; surgery

Dermatomyositis is a rare and idiopathic inflammatory myopathy with characteristic cutaneous manifestations. A 61-year-old female presented with the chief complaints of proximal muscle weakness, facial edema and erythema on the face, chest and back. The patient was diagnosed with dermatomyositis by the clinical manifestation, laboratory findings and an electromyogram. After a year following appropriate treatment, a tonsil cancer was found. The patient was treated with three rounds of neoadjuvant chemotherapy and wide excision of the left tonsil. In Korea, a few cases of dermatomyositis have been reported associated with stomach cancer, breast cancer, acute lymphoblastic leukemia and lung cancer, but no associated cases with tonsil cancer have yet been reported. We report a case of tonsil cancer that developed in a patient with dermatomyosits during therapy.
Breast Neoplasms ; Dermatomyositis* ; Drug Therapy ; Edema ; Erythema ; Female ; Humans ; Korea ; Lung Neoplasms ; Middle Aged ; Muscle Weakness ; Myositis ; Palatine Tonsil* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stomach Neoplasms ; Thorax ; Tonsillar Neoplasms*

OBJECTIVE: To evaluate the treatment of advanced tonsillar carcinoma by radiotherapy plus salvage surgery (R+S) or surgery coupling with postoperative radiotherapy (S+R). METHOD: Clinical data of 48 patients with advanced tonsillar carcinoma who were treated in The 2nd Affiliated Hospital of Sun Yat-sen University from June 1996 to June 2004 was retrospectively analyzed. The patients were divided into R+S group (group A, 21 cases) and S+R group (group B, 27 cases). Treatment outcomes were compared between these two groups. The QOL (quality of life) scale of Washington University (UW-QOL) was used to investigate the patient's quality of life. RESULT: The 5-year survival rates were 42.9% in group A and 45.8% in group B, there was no significant statistical difference between the two groups (P < 0.05). Both the two treatment modalities could reduce the QOL in some degree. The average QOL score of 46 patients was 661.00 +/- 98.52 , group A was 696.09 + 90.70, while group B was 631.52 +/- 96.74, there was a significant statistical difference between the two groups (P < 0.05). CONCLUSION The two treatment modalities reached similar survivals. However, compared with the S+R, some patients who accepted treatment of R+S could avoid composite resection, reduce functional lesion and improve the QOL.
Adult ; Aged ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; therapy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Survival Rate ; Tonsillar Neoplasms ; radiotherapy ; surgery ; therapy ; Treatment Outcome

OBJECTIVETo discuss treatment options for tonsillar squamous cell carcinoma.

METHODSA total of 108 patients with biopsy-proven tonsillar squamous cell carcinoma, treated between 1984 and 2000, were reviewed, including 82 men and 26 women, with ages ranging from 19 to 70 years. Treatments consisted of either radiotherapy and surgery reserved as salvage treatment (Salvage Surgery, 83 patients), or planned surgery with preoperative radiation (Planned Surgery, 25 patients). Radiotherapy was delivered primarily in a dosage of 60 - 70 Gy for Salvage Surgery patients and 40 - 50 Gy for Planned Surgery patients. Both salvage and planned surgeries were radical, with resection of the lateral oropharyngeal wall, segmental resection of the mandible and neck dissection. The pectoralis major myocutaneous flaps were used to repair surgical defects.

RESULTSThe percentages of radical surgery used in the Salvage Surgery and Planned Surgery groups were 24.1% (20/83) and 88.0% (22/25), respectively (P = 0.000). The local recurrence rates were 28.9% (24/83) and 20.0% (5/25) in the Salvage Surgery and Planned Surgery groups, respectively (P = 0.378). The neck recurrence rates were 9.6% (8/83) and 8.0% (2/25) in the Salvage Surgery and Planned Surgery groups respectively (P = 0.804). The 5-year survival rates were 59.3% and 55.3% in the Salvage Surgery and Planned Surgery groups, respectively (P = 0.7056).

CONCLUSIONSAlthough the two treatments had a similar survival rate, Salvage Surgery avoided 60% commando operations compared with the Planned Surgery group, which benefits to recovery of oral functions. Primary radiotherapy is recommended as the treatment of choice for tonsillar squamous cell carcinoma. After radical radiotherapy, salvage surgery should be undertaken in the case of tumor remnants or recurrences.

Adult ; Aged ; Carcinoma, Squamous Cell ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Salvage Therapy ; Tonsillar Neoplasms ; therapy ; Treatment Outcome