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Management of Cervical Metastases in Advanced Squamous Cell Carcinoma of the Tonsillar Fossa Following Radiotherapy
Ted Mau, MD, PhD;
Young Oh, MD;
M. Kara Bucci, MD;
David W. Eisele, MD
Arch Otolaryngol Head Neck Surg. 2005;131:600-604.
Objective To assess the value of planned neck dissection in patients with a complete response to definitive radiotherapy for squamous cell carcinoma of the tonsillar fossa with advanced nodal disease.
Design Case series.
Setting Academic tertiary care medical center.
Patients A consecutive series of 36 patients with squamous cell carcinoma of the tonsillar fossa with N2 or N3 nodal disease treated with primary radiation therapy with or without concurrent chemotherapy between January 1, 1992, and April 1, 2003, at the University of California, San Francisco, Comprehensive Cancer Center. Patients treated with primary surgery, those treated with palliative intent, or those with preexisting malignancies were excluded.
Main Outcome Measures Regional control and overall survival.
Results Of the study group, 15 patients (42%) achieved a complete response, 17 (47%) achieved a partial response, and 1 (3%) was a nonresponder. The response in 3 patients (8%) could not be assessed. Of the 15 patients with a complete response, only 2 (13%) later developed regional recurrences, 1 of which was an isolated recurrence in the neck. Regional control and overall survival at 3 years were 78% and 48%, respectively.
Conclusions The rate of regional recurrence after a complete response to radiation therapy with or without concurrent chemotherapy for tonsillar squamous cell carcinoma with advanced cervical metastases is low. Our results support close surveillance of the neck in those who have achieved a complete response after radiation therapy with or without chemotherapy.
Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Drs Mau, Oh, and Eisele) and Radiation Oncology (Dr Bucci), University of California, San Francisco.
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