为了表征诸如淋巴结负担、治疗前成像和其他可能影响同侧颈部放疗（IRT）在有多个涉及同侧结点的扁桃体鳞状细胞癌（SCC）中的作用的患者因素。确定了在1990年1月1日至2019年10月1日期间在杜克大学医学中心接受过明确放射治疗（RT）的cT1-2N0-2bM0（AJCC第7版）扁桃体SCC的患者。比较了接受双侧颈部RT（BRT）和IRT的患者的患者、肿瘤和治疗特点。使用Kaplan-Meier方法估计了无复发生存期（RFS）。对N2b疾病的患者进行了亚组分析。分析了复发的模式。识别了120名患有cT1-2N0-2b扁桃体SCC的患者，其中71名患有N2b疾病（BRT：n = 30；IRT：n = 41）。中位随访时间为80个月（范围：7-209）。接受IRT的N2b患者中，没有人的软腭/舌根延伸大于1cm。接受IRT治疗的N2b患者具有中位数为3（范围为2-9）的涉及淋巴结，并且具有中位最大结节尺寸为2.8cm（范围为1.3-4.8cm）。93％的接受IRT的N2b患者进行了PET / CT分期检查，100％接受了IMRT。对于接受IRT治疗的N2b患者，没有对侧颈复发，并且10年RFS为95％（95％CI为82％-98％）。对于接受IRT治疗的N2b扁桃体SCC病灶，我们观察到高水平的局部控制率，并且没有观察到对侧颈复发。这些数据表明，在基线PET / CT分期的情况下，对于具有多个涉及同侧淋巴结的患者，BRT不是必需的。版权所有©2023 Elsevier Ltd。保留全部权利。

To characterize factors including nodal burden, pre-treatment imaging, and other patient factors which may influence the role of ipsilateral neck radiotherapy (IRT) in tonsillar squamous cell carcinoma (SCC) with multiple involved ipsilateral nodes.Patients with cT1-2N0-2bM0 (AJCC 7th edition) tonsillar SCC treated with definitive radiation therapy (RT) at Duke University Medical Center from 1/1/1990-10/1/2019 were identified. Patient, tumor, and treatment characteristics were compared between those that received bilateral neck RT (BRT) versus IRT. Recurrence-free survival (RFS) was estimated with Kaplan-Meier method. A subset analysis of patients with N2b disease was performed. Patterns of recurrence were analyzed.120 patients with cT1-2N0-2b tonsillar SCC were identified, including 71 with N2b disease (BRT: n = 30; IRT: n = 41). Median follow-up was 80 months (range: 7-209). No N2b patients who received IRT had > 1 cm of soft palate/base of tongue extension. N2b patients treated with IRT had a median of 3 (range 2-9) involved lymph nodes, with median largest nodal dimension of 2.8 cm (range 1.3-4.8 cm). 93 % of N2b patients who received IRT had staging by PET/CT, and 100 % received IMRT. For N2b patients treated with IRT, there were no contralateral neck recurrences, and 10 year RFS was 95 % (95 % CI 82 %-98 %).For patients treated with IRT for well-lateralized N2b tonsillar SCC, we observed high rates of local control with no observed contralateral neck recurrence. These data suggest that BRT is not universally necessary for patients with multiple involved ipsilateral nodes, particularly in the setting of baseline staging with PET/CT.Copyright © 2023 Elsevier Ltd. All rights reserved.