通过简单的扁桃腺切除术常常可以诊断出腭扁桃体小型癌症，这种操作没有治疗目的。本研究评估了这种特殊情况下的实践模式。在10个医疗机构进行的回顾性研究中，纳入了2010年至2018年间通过简单扁桃腺切除术诊断出cT1-2型鳞状细胞癌的患者。纳入的患者只接受了以治愈为目标的调强放射治疗（IMRT），没有进行其他手术。对靶体积进行了复查，并计算了局部复发率和严重迟发性吞咽困难的累积发病率。 在638例咽喉患者中，通过简单扁桃腺切除术诊断出91例。其中，57例接受了针对原发灶的IMRT治疗而没有进行其他手术，除去有残留病变的3例，纳入分析的有54例。边缘阴性的占13%，边缘紧贴（<5 mm）的占13%，显微镜下阳性的占61%，未报告的占13%。通常给予原发病变所接受的剂量（68-70.2 Gy，分33-35次或66 Gy/30次）的剂量被用于37例（69%）扁桃体区域。16例患者（29%）接受了60到66 Gy的剂量（≤2 Gy/fx），1例接受了50 Gy的剂量（2 Gy/fx）。未观察到局部复发。发生了1例晚期咽喉软组织溃疡，经保守治疗（2级）。经过5年，严重迟发性吞咽困难的累积发病率为17.4%（95% CI 6.1-28.8%）。 通过简单扁桃腺切除术诊断出的小型扁桃体癌是一种具有良好肿瘤学结果的特殊子集。尽管如此，放射肿瘤学家倾向于对扁桃体区域进行全剂量放射治疗。在当代，这种例行程序的必要性可能会受到质疑。 版权所有 © 2023 Elsevier Ltd. 保留所有权利。

Small carcinomas of the palatine tonsil are often diagnosed via simple tonsillectomy, a maneuver with non-therapeutic intent. Herein, practice patterns for this unique situation are evaluated.A retrospective review was performed across 10 facilities to identify patients with cT1-2 squamous carcinomas of the tonsil diagnosed by simple tonsillectomy between 2010 and 2018. Patients who received curative-intent intensity modulated radiotherapy (IMRT) without additional surgery were included. Target volumes were reviewed, and cumulative incidences of local failure and severe late dysphagia were calculated.From 638 oropharyngeal patients, 91 were diagnosed via simple tonsillectomy. Definitive IMRT with no additional surgery to the primary site was utilized in 57, and three with gross residual disease were excluded, leaving 54 for analysis. Margins were negative in 13%, close (<5 mm) in 13%, microscopically positive in 61%, and not reported in 13%. Doses typically delivered to gross disease (68-70.2 Gy in 33-35 fx or 66 Gy/30 fx) were prescribed to the tonsil bed in 37 (69%). Sixteen patients (29%) received doses from 60 to 66 Gy (≤2 Gy/fx) and one received 50 Gy (2 Gy/fx). No local failures were observed. One late oropharyngeal soft tissue ulcer occurred, treated conservatively (grade 2). At five years, the cumulative incidence of severe late dysphagia was 17.4% (95% CI 6.1-28.8%).Small tonsil carcinomas diagnosed by simple tonsillectomy represent a niche subset with favorable oncologic outcomes. Regardless, radiation oncologists tend to deliver full-dose to the tonsil bed. The necessity of this routine could be questioned in the modern era.Copyright © 2023 Elsevier Ltd. All rights reserved.