The following is a summary of “Radiation therapy for cT1-2 carcinoma of the palatine tonsil diagnosed via a simple tonsillectomy: Dosimetry and patterns of care in the IMRT era,” published in the November 2023 issue of Oncology by Ward, et al.

A simple tonsillectomy is not meant to treat anything and is often used to find small carcinomas in the palatine tonsil. In this section, practice methods for this specific case are looked at. For a study, researchers sought to look back at records from 10 sites to find patients who had cT1-2 squamous carcinomas of the tonsil removed during a simple tonsillectomy between 2010 and 2018. People who got intensity-modulated radiotherapy (IMRT) to cure their cancer without needing more surgery were included. The target amounts were looked at again, and the total number of times there was local failure and serious late dysphagia was found. Of 638 people with oropharyngeal problems, 91 were identified with a standard tonsillectomy. 

In 57 cases, definitive IMRT was used without extra treatment at the main site. Three cases with gross leftover disease were ruled out, leaving 54 cases for study. 13% of the margins were negative, 13% were close (<5 mm), 61% were microscopically positive, and 13% were not recorded. Doses are usually given to treat severe sickness (68–70).66 Gy/30 fx or 2 Gy in 33–35 fx) were given to the tonsil bed in 37 (69%). Sixteen cases, or 29%, got amounts between 60 and 66 Gy (≤2 Gy/fx), and one got 50 Gy (2 Gy/fx). There were no neighborhood problems seen. 

One late oropharyngeal soft tissue ulcer happened and was treated with careful measures (grade 2). After five years, 17.4% (95% CI: 6.1–28.8%) of people had severe late dysphagia. Small tonsil carcinomas found by a simple tonsillectomy are a specific type of cancer with good results. No matter what, radiation doctors usually give the tonsil bed the full dose. These days, it might not be necessary to follow this practice.

Source: sciencedirect.com/science/article/abs/pii/S1368837523002531