Patients Report Less Severe Symptoms With Unilateral Radiation Therapy Than Bilateral Radiation Therapy for Tonsillar Squamous Cell Carcinomas

Abstract

total volume of 74.0AE14.5 cc), the average percent volumes receiving minimal LQED2 of 70 (V 70) Gy (corresponding to BED of 116.7 Gy 3) was 12.4AE15.5%, corresponding to an absolute mandibular volume of 8.3AE10.1 cc. Thus, while the mandible might be considered as a serial organ as far as ORN is concerned, it might be associated with a moderate volume effect. Conclusion: ORN can result from increased LQED2 or BED which may not be conspicuous from a dosimetric plan based solely on physical dose display. This study demonstrates the utilization of radiobiologically sound dosimetry which clinicians can use to quantify risk of late complications due to the "double trouble" arising from altered fractionation schemes. For the mandible, DVH guidelines based on BED or LQED2 might be better representations to predict true incidence of ORN, and useful when constructing the doseresponse relation as a normal-tissue complication probability (NTCP) curve.

Patient-reported quality of life and toxicity in unilateral and bilateral radiotherapy for early-stage human papillomavirus associated tonsillar carcinoma

“…To our knowledge this is one of the few studies to contrast selfreported, long-term QoL in early-stage tonsillar carcinoma patients treated with definitive URT and BRT in the IMRT era, suggesting worse long-term QoL and toxicity with BRT. In contrast to other series reporting toxicity outcomes [18][19][20], all our patients were confirmed cases of HPV + tonsillar carcinoma and all were treated with IMRT. This is a cross-sectional study, and while we accept some inevitable selection bias, this data illustrates the relative estimate of the long-term impact of BRT in patients with lateralized tonsillar carcinoma.…”

“…We also noted that the assessment time was longer in their cohort (mean 5.1 versus 3.2 years), although in general it would be expected that for most, the toxicity profile would remain stable over this interval. A small series (n = 30; 15 URT, 15 BRT) from Roswell Park has also been presented in abstract form, reporting sim- ilar findings to ours, in that URT may be associated with an improved toxicity profile (EORTC QLQ-C30 and H&N35 modules), but details about staging, selection criteria for URT and BRT and use of chemotherapy were not included in the abstract [20]. A comprehensive study of clinician-scored toxicity by Jensen et al with field based radiotherapy treatment showed a more favourable toxicity profile with URT over BRT [19].…”