An 11-year-old male neutered Maltese cross referred for radiation therapy of right tonsil squamous cell carcinoma.

Patient History

Owners noted a change in bark in August which persisted over several marks. Subsequently some gagging was observed with diminished appetite. Patient presented to the oncology team with a right sided tonsil mass displacing the soft palate ventrally was noted on oral exam.


On 17/9/2018 a CT scan was done which showed a contrast enhancing mass originating within the right tonsil and extending out of the tonsillar crypt into the surrounding soft tissues with ventral displacement of the soft palate. A needle aspirate of the mass was consistent with a tonsillar SCC. Thoracic CT scan showed no evidence of metastatic lung legions and the regional lymph nodes were within normal limits.


Given the extent of the tumour and degree of local tissue invasion the patient was set up to start radiation therapy. He received 5 X 7Gy fractions to a total dose of 35Gy and commenced treatment on 19/9/2018.


The tumour responded very well to therapy and at 1 week post treatment the mass notably reduced in size with only a mild mucositis evident within the right oropharynx region. A follow up CT scan was done on 23/10/2018 and showed complete resolution of the mass effect. The mucositis was completely resolved by this time and an adjuvant course of carboplatin was initiated. The patient showed disease recurrence in August 2019 and received a second course of palliative radiation therapy but passed away in September 2019 13 months after diagnosis.

Stereotactic radiation therapy (SRT) 5 day course of treatment to the left subscapular region

SRT was prescribed to the right tonsil region as a non-surgical alternative.

35Gy in 5 fractions to the Target volume

VMAT fields are used to provide excellent treatment, preserving healthy tissue and critical surrounding structures.

Daily Cone Beam CT was used to verify the accuracy and precision of treatment.

15 minute treatment time including daily image guided radiation therapy (IGRT).