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Chemoradiotherapy versus surgery followed by postoperative radiotherapy in tonsil cancer: Korean Radiation Oncology Group (KROG) study

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Authors
Song, Sanghyuk; Wu, Hong-Gyun; Lee, Chang Geol; Keum, Ki Chang; Kim, Mi Sun; Ahn, Yong Chan; Oh, Dongryul; Park, Hyo Jung; Lee, Sang-Wook; Park, Geumju; Moon, Sung Ho; Cho, Kwan Ho; Kim, Yeon-Sil; Won, Yongkyun; Oh, Young-Taek; Kim, Won-Taek; Jeong, Jae-Uk
Issue Date
2017-08-30
Publisher
BioMed Central
Citation
BMC Cancer, 17(1):598
Keywords
Tonsil cancerChemoradiotherapySurgeryAdjuvant radiotherapyInduction chemotherapy
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Abstract
Abstract

Background
Treatment of tonsil cancer, a subset of oropahryngeal cancer, varies between surgery and radiotherapy. Well-designed studies in tonsil cancer have been rare and it is still controversial which treatment is optimal. This study aimed to assess the outcome and failure patterns in tonsil cancer patients treated with either approaches.

Methods
We retrospectively reviewed medical records of 586 patients with tonsil cancer, treated between 1998 and 2010 at 16 hospitals in Korea. Two hundred and one patients received radiotherapy and chemotherapy (CRT), while 385 patients received surgery followed by radiotherapy and/or chemotherapy (SRT). Compared with the SRT group, patients receiving CRT were older, with more advanced T stage and received higher radiotherapy dose given by intensity modulation techniques. Overall survival (OS), disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and clinicopathologic factors were analyzed.

Results
At follow-up, the 5-year OS, DFS, LRRFS and DMFS rates in the CRT group were 82, 78, 89, and 94%, respectively, and in the SRT group were 81, 73, 87, and 89%, respectively. Old age, current smoking, poor performance status, advanced T stage, nodal involvement, and induction chemotherapy were associated with poor OS. Induction chemotherapy had a negative prognostic impact on OS in both treatment groups (p = 0.001 and p = 0.033 in the CRT and SRT groups, respectively).

Conclusions
In our multicenter, retrospective study of tonsil cancer patients, the combined use of radiotherapy and chemotherapy resulted in comparable oncologic outcome to surgery followed by postoperative radiotherapy, despite higher-risk patients having been treated with the definitive radiotherapy. Induction chemotherapy approaches combined with either surgery or definitive radiotherapy were associated with unfavorable outcomes.
ISSN
1471-2407
Language
English
URI
http://hdl.handle.net/10371/138281
DOI
https://doi.org/10.1186/s12885-017-3571-3
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College of Medicine/School of Medicine (의과대학/대학원)Radiation Oncology (방사선종양학전공)Journal Papers (저널논문_방사선종양학전공)
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