TY - JOUR
T1 - Five-year outcomes of an oropharynx-directed treatment approach for unknown primary of the head and neck
AU - Hu, Kenneth Shung
AU - Mourad, Waleed Fouad
AU - Gamez, Mauricio E.
AU - Lin, Wilson
AU - Jacobson, Adam Saul
AU - Persky, Mark Stephen
AU - Urken, Mark L.
AU - Culliney, Bruce E.
AU - Li, Zujun
AU - Tran, Theresa Nguyen
AU - Schantz, Stimson Pryor
AU - Chadha, Juskaran
AU - Harrison, Louis Benjamin
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Purpose Squamous cell carcinoma of unknown primary (SCCHNUP) is commonly treated with comprehensive radiation to the laryngopharynx and bilateral necks. In 1998, we established a departmental policy to treat SCCHNUP with radiation directed to the oropharynx and bilateral neck. Methods From 1998–2011, 60 patients were treated – N1: 18%, N2: 75% and N3: 7%. 82% underwent neck dissection. 55% received IMRT and 62% underwent concurrent chemoradiotherapy. Results At median follow-up of 54 months, 5 patients failed regionally and 4 emerged with a primary (tongue base, hypopharynx and thoracic esophagus). Five-year rates of regional control, primary emergence, distant metastasis, disease-free survival and overall survival were 90%, 10%, 20%, 72% and 79%, respectively. The 5 year rate of primary emergence in a non-oropharynx site was 3%. Conclusion This is the first demonstration that an oropharynx-directed approach yields low rates of primary emergence in SCCHNUP with excellent oncologic outcomes.
AB - Purpose Squamous cell carcinoma of unknown primary (SCCHNUP) is commonly treated with comprehensive radiation to the laryngopharynx and bilateral necks. In 1998, we established a departmental policy to treat SCCHNUP with radiation directed to the oropharynx and bilateral neck. Methods From 1998–2011, 60 patients were treated – N1: 18%, N2: 75% and N3: 7%. 82% underwent neck dissection. 55% received IMRT and 62% underwent concurrent chemoradiotherapy. Results At median follow-up of 54 months, 5 patients failed regionally and 4 emerged with a primary (tongue base, hypopharynx and thoracic esophagus). Five-year rates of regional control, primary emergence, distant metastasis, disease-free survival and overall survival were 90%, 10%, 20%, 72% and 79%, respectively. The 5 year rate of primary emergence in a non-oropharynx site was 3%. Conclusion This is the first demonstration that an oropharynx-directed approach yields low rates of primary emergence in SCCHNUP with excellent oncologic outcomes.
KW - Emergence
KW - Oropharynx
KW - Radiation
KW - Unknown primary
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U2 - 10.1016/j.oraloncology.2017.05.001
DO - 10.1016/j.oraloncology.2017.05.001
M3 - Article
C2 - 28622886
AN - SCOPUS:85019160768
SN - 1368-8375
VL - 70
SP - 14
EP - 22
JO - Oral Oncology
JF - Oral Oncology
ER -
