Patient-reported quality of life and toxicity in unilateral and bilateral radiotherapy for early-stage human papillomavirus associated tonsillar carcinoma.

•Unilateral radiotherapy is utilised in T1-2, N0-N1 lateralised tonsillar tumours.•The role of unilateral radiotherapy in more advanced nodal disease is less clear.•Higher symptom burden and lower QoL was reported by patients treated with bilateral radiotherapy.•In the IMRT era, bilateral treatment for tonsillar cancer may have an enduring impact on the patient.•Prospective evaluation of unilateral radiotherapy with lateralised tumours and N2-3 is needed.