BACKGROUND: The purpose of this study is to present our experience treating patients with squamous cell carcinoma (SCC) from an unknown head and neck primary site and to determine whether a policy change eliminating the larynx and hypopharynx from the radiotherapy (RT) portals has impacted outcome. METHODS: One hundred seventy-nine patients received definitive RT with or without a neck dissection for SCC from an unknown head and neck primary site. RT was delivered to the ipsilateral neck alone or both sides of the neck and, usually, the potential mucosal primary sites. The median mucosal dose was 5670 cGy. The median neck dose was 6500 cGy. One hundred nine patients (61%) received a planned neck dissection. RESULTS: Mucosal control at 5 years was 92%. The mucosal control rate in patients with RT limited to the nasopharynx and oropharynx was 100%. The 5-year neck-control rates were as follows: N(1), 94%; N(2a), 98%; N(2b), 86%; N(2c), 86%; N(3), 57%; and overall, 81%. The 5-year cause-specific survival rates were as follows: N(1), 94%; N(2a), 88%; N(2b), 82%; N(2c), 71%; N(3), 48%; and overall, 73%. The 5-year overall survival rates were as follows: N(1), 50%; N(2a), 70%; N(2b), 59%; N(2c), 45%; N(3), 34%; and overall, 52%. Eleven patients (7%) developed severe complications. CONCLUSION: RT alone or combined with neck dissection results in a high probability of cure with a low risk of severe complications. Eliminating the larynx and hypopharynx from the RT portals did not compromise outcome and likely reduces treatment toxicity.
BACKGROUND: The purpose of this study is to present our experience treating patients with squamous cell carcinoma (SCC) from an unknown head and neck primary site and to determine whether a policy change eliminating the larynx and hypopharynx from the radiotherapy (RT) portals has impacted outcome. METHODS: One hundred seventy-nine patients received definitive RT with or without a neck dissection for SCC from an unknown head and neck primary site. RT was delivered to the ipsilateral neck alone or both sides of the neck and, usually, the potential mucosal primary sites. The median mucosal dose was 5670 cGy. The median neck dose was 6500 cGy. One hundred nine patients (61%) received a planned neck dissection. RESULTS: Mucosal control at 5 years was 92%. The mucosal control rate in patients with RT limited to the nasopharynx and oropharynx was 100%. The 5-year neck-control rates were as follows: N(1), 94%; N(2a), 98%; N(2b), 86%; N(2c), 86%; N(3), 57%; and overall, 81%. The 5-year cause-specific survival rates were as follows: N(1), 94%; N(2a), 88%; N(2b), 82%; N(2c), 71%; N(3), 48%; and overall, 73%. The 5-year overall survival rates were as follows: N(1), 50%; N(2a), 70%; N(2b), 59%; N(2c), 45%; N(3), 34%; and overall, 52%. Eleven patients (7%) developed severe complications. CONCLUSION: RT alone or combined with neck dissection results in a high probability of cure with a low risk of severe complications. Eliminating the larynx and hypopharynx from the RT portals did not compromise outcome and likely reduces treatment toxicity.
Authors: Candan Demiroz; Jeffrey M Vainshtein; Georgios V Koukourakis; Orit Gutfeld; Mark E Prince; Carol R Bradford; Gregory T Wolf; Scott McLean; Francis P Worden; Douglas B Chepeha; Matthew J Schipper; Jonathan B McHugh Journal: Head Neck Date: 2013-11-18 Impact factor: 3.147
Authors: Basel Al Kadah; Giorgos Papaspyrou; Maximilian Linxweiler; Bernhard Schick; Christian Rübe; Benjamin Simeon Büchler; Marcus Niewald Journal: Eur Arch Otorhinolaryngol Date: 2017-03-17 Impact factor: 2.503
Authors: Lanea M Keller; Thomas J Galloway; Thomas Holdbrook; Karen Ruth; Donghua Yang; Cara Dubyk; Douglas Flieder; Miriam N Lango; Ranee Mehra; Barbara Burtness; John A Ridge Journal: Head Neck Date: 2014-01-13 Impact factor: 3.147
Authors: Matthias Balk; Robin Rupp; Konstantinos Mantsopoulos; Matti Sievert; Magdalena Gostian; Moritz Allner; Philipp Grundtner; Markus Eckstein; Heinrich Iro; Markus Hecht; Antoniu-Oreste Gostian Journal: J Clin Med Date: 2022-05-10 Impact factor: 4.964