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

Abstract

The goal of this study was to examine the effects of radiation treatment volume on quality of life in patients with squamous cell carcinoma of the tonsil. Clinical characteristics of patients with tonsillar squamous cell carcinoma (n=30) treated at Roswell Park Cancer institute (2013-2015) were abstracted from the medical records. Patients were either treated with radiation therapy to one side of the head and neck, unilateral radiation (n=15), or treated with radiation therapy to both sides of the head and neck, bilateral radiation (n=15). Quality of life data was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-30) and head and neck 35 (H&N 35). The EORTC survey was administered prior to the start of radiation therapy treatment, at the end of radiation therapy treatment, and at each follow-up appointment up to 1-year posttreatment. Mann Whitney U tests were used to examine differences in QOL scores between patients treated unilaterally and patients treated bilaterally at various time points posttreatment. Patients who received bilateral treatment had significantly more appetite loss six months posttreatment (55.56% vs 15.15%, t=2.92, P=.02), more dysphagia 3 months posttreatment (40.48% vs 13.63%, t=2.85, P=.03), and more xerostomia e month posttreatment (62.5% vs 33.33%, t=2.37, P=.0486) than patients receiving unilateral radiation. Unilateral patients reported more sticky saliva posttreatment (93.33% vs 75.56%, t=-2.12, P=.01) than patients who received bilateral treatment. Results of this small cohort study indicate that unilateral radiation therapy in tonsillar squamous cell carcinoma may be associated with less severe symptoms than bilateral radiation therapy and more studies on a larger scale are needed to further investigate this association.