Treatment of head and neck carcinoma of unknown primary: Cracking a nut with a sledgehammer?

Laryngoscope Investigative Otolaryngology

article

Diako Berzenji BSc¹  Dominiek A. Monserez MD¹  Gerda M. Verduijn MD²  Emilie A.C. Dronkers MD, PhD¹  Peter P. Jansen MD²  Stijn Keereweer MD, PhD¹  Aniel Sewnaik MD, PhD¹  Robert J. Baatenburg de Jong MD, PhD¹  Jose A. Hardillo MD, PhD¹ 

[1] Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center;Department of Radiation Oncology, Erasmus University Medical Center

关键词: cancer of unknown primary;    head and neck carcinoma;    pharyngeal axis;    radiation toxicity;    radiotherapy;   

DOI  :  10.1002/lio2.539

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objectives To compare the impact on survival and late radiation toxicity of patients with squamous cell carcinoma of unknown primary who were treated with ipsilateral neck dissection and ipsilateral postoperative radiotherapy (PORT) and patients treated with ipsilateral neck dissection and PORT to both sides of the neck plus the pharyngeal axis. Methods Retrospective cohort study performed at the Erasmus University Medical Center in which 78 patients with squamous cell carcinoma of unknown primary were identified. Thirty-nine patients received PORT to both sides of the neck plus the pharyngeal axis (BILAX) and another 39 patients were irradiated on the ipsilateral neck (IPSI) only. The endpoints of the present study were 3-year overall survival (OS), 3-year disease-free survival (DFS), and overall late radiation toxicity. Results The 3-year OS rate of the entire group of 78 patients was 74.2% and the 3-year DFS rate was 72.7%. The 3-year OS rates for the IPSI and the BILAX groups were 74.4% and 74.1%, respectively ( P = .654). The most common late radiation toxicity experienced was xerostomia (64.8%), which was significantly more often seen in the BILAX group than in the IPSI group (83.8% and 44.1%, respectively, P = .001). Overall late radiation toxicity was significantly higher in the BILAX group ( P = .003). Conclusion There was no significant difference in OS and DFS rates between the IPSI and the BILAX group. Late radiation toxicity was significantly higher in the BILAX group. Level of Evidence Level 2b: Individual retrospective cohort study.

【 授权许可】

CC BY|CC BY-NC-ND