PURPOSE: To assess the efficacy of a concomitant boost fractionation schedule of radiotherapy for treating @entity1 with @entity957 of the tonsillar fossa. @entity1 AND METHODS: Between December 1983 and November 1992, 83 @entity1 with @entity957 of the tonsil were treated with concomitant boost fractionation. The distribution of American Joint Committee on @entity5 stages was TX-4, T1-5, T2-29, T3-41, T4-4; N stages were NX-1, N0-26, N1-13, N2-31, N3-12. @entity1 were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment consisted of a second daily 1.5 Gy fraction for 10-12 fractions, usually delivered during the final phase of treatment. The @entity5 dose was 69-72 Gy, given over 6 weeks. Twenty-one @entity1 , who all had N2 or N3 regional disease, underwent neck dissections, either before (13 @entity1 ) or 6 weeks after radiotherapy (8 @entity1 ); the other @entity1 were treated with radiotherapy alone. RESULTS: The 5-year actuarial disease-specific survival and overall survival rates were 71 and 60%, respectively. @entity1 with T2 and T3 @entity5 had 5-year actuarial local control rates of 96 and 78%, respectively. @entity1 with T3 disease who received the final-phase boost had a 5-year actuarial local control rate of 82%. Actuarial 5-year regional disease control rates were N0, 92%; N1, 76%; N2, 89%; and N3, 89%. The 21 @entity1 who had neck dissections all had their disease regionally controlled. @entity1 presenting with @entity66 or after a node excision who were treated with radiation alone had a 5-year actuarial regional disease control rate of 79%. All but five @entity1 had confluent Grade 4 @entity33 during treatment. Severe late complications attributable to radiation included mandibular necrosis [1], in-field @entity421 [1], and chronic @entity1282 for solid foods [5]. CONCLUSIONS: High rates of local and regional disease control were achieved with the concomitant boost fractionation schedule, with few cases of severe late morbidity. @entity1 with N2 and N3 neck disease were effectively treated with radiation and the selective use of neck dissections. The concomitant boost schedule is our preferred fractionation approach for treating @entity1 with intermediate stage tonsil @entity5 who are not participating in our current research protocols.

Concomitant boost radiotherapy for XXXX of the tonsillar fossa.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity66 :: ('MESH:D004194', 'Disease') :: ['nodal disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'primary tumors', 'cancer', 'Cancer T'] @entity957 :: ('MESH:D002294', 'Disease') :: ['squamous carcinoma'] @entity33 :: ('MESH:D052016', 'Disease') :: ['mucositis'] @entity421 :: ('MESH:D012516', 'Disease') :: ['osteosarcoma'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia']
@entity957 :: (MESH:D002294,Disease) :: ['squamous carcinoma']
