I have seen some T1 patients have chemoradiation, just radiation, including myself, and it depends on the doctor, institution, tumor size, thickness, area of primary, nodal involvement, patient. NCCN is just a guideline.

BOT can be persistent tumor, more difficult to treat, due to the deep musculature, lymphatics in the area for tumor to spread, go deeper in the BOT. Was chemoradiation offered or just a question?

I have a long history with T1 tonsil confirmed by biopsy, possibly BOT, valeculla involvement by PET, but not found in tissue sample. Was scheduled for Induction Chemo, followed by concurrent chemo radiation, but reaction to IC prevented that. 5 days IC killed the tonsil cancer, but it returned, as I later read would happen in less than a year. Anyway, had 4 more recurrences after that went into my neck muscle, skin, outside of primary and lymphs somehow to be "free form" or "roaming cancer" in my neck that can spread anywhere. Had positive margins from one surgery, Perineural and lymphovasvular invasion, so cancer can travel anywhere along the blood and veins lines too, and needed a number of treatments, radiation, surgeries. i have been continuously in some form of CRT treatment, recovery, surgery, dental, HBO, transfusions for 3.5 years for an original T1N2bMO.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs