Patients with squamous cell tonsil cancer who were treated with radiation to one side of the neck experienced excellent cancer control and a low risk of recurrence on the other side, according to the results of a retrospective analysis that was reported at the Multidisciplinary Head and Neck Cancer Symposium in Chandler, Arizona, in February 2010.
The study included 102 patients with squamous cell carcinoma of the tonsil who were treated at M. D. Anderson Cancer Center between 1970 and 2007. All patients had primary disease that was restricted to the tonsillar fossa or pillar, with zero or minimal involvement of the soft palate. Depending on the era of treatment, patients were treated with one of the following unilateral radiotherapy techniques: appositional mixed beam of photons and electrons (1970-1988); wedge pair photon technique (1989-2003); or intensity modulated radiotherapy (2004-2007). Median follow-up was 3.2 years.
The data indicate that the treatment method resulted in 100% locoregional control at the primary disease site and the neck on the same side. Contralateral recurrence (meaning disease that returned on the opposite side) occurred in two patients, or a crude rate of 2%. Five-year overall survival was 95% and five-year disease-free survival was 96%. Five-year freedom from contralateral failure was 96%.
The researchers concluded that unilateral radiotherapy provides excellent locoregional control for tonsil cancer in appropriately selected patients, with a low risk of contralateral recurrence.
 Chronowski GM, Garden AS, Morrison WH, et al. Ipsilateral radiotherapy in the treatment of squamous cell carcinoma of the tonsil. Presented at the Multidisciplinary Head and Neck Cancer Symposium, February 25-27, 2010, Chandler, Arizona. Abstract # LB1.