Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck

Waleed F. Mourad, S. H.U. Kenneth, Daniel Shasha, Catherine Concert, D. A.N. Ishihara, L. I.N. Wilson, Rania A. Shourbaji, Magdalena Ryniak, Mauricio E. Gamez, John N. Lukens, L. I. Zujun, Bruce E. Culliney, Azita S. Khorsandi, Theresa Tran, Adam Jacobson, Spiros Manolidis, Stimson Schantz, Mark Urken, Mark S. Persky, Louis B. Harrison

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Aim: Metastasis of unknown primary (MUP) is commonly treated with radiation therapy (RT) to the entire mucosal surfaces and bilateral neck nodes (LN). We report outcomes of oropharynx-targeted RT, retropharyngeal nodes (RPN) and bilateral LN in this context. Patients and Methods: Single-Institution retrospective study of 68 patients. Forty percent were treated with intensity-modulated radiation therapy (IMRT). Fifty-six percent received concurrent chemoradiotherapy (CCRT). The median age was 58 years, 82% were Caucasian, and 75% males. Stage III disease was present in 9%, stage IVA in 75% and IVB in 16%. Results: At a median follow-up of 3.5 years, the actuarial locoregional control was 95.5%. The emergence of primary developed in 1patient (1.5%) and 2patients (3%) failed in the neck. The median time-to-locoregional failure (LRF) was 18 months. Actuarial long-term RT toxicity was grade 1 xerostomia (68%), dysphagia (35%), neck stiffness (15%) and trismus (6%). Conclusion: RT to the oropharynx, RPN, and bilateral neck provides excellent oncological and functional outcomes in MUP in non-Asian patients. Sparing the mucosal surfaces of the nasopharynx, hypopharynx, and larynx seems reasonable without impacting on survival and locoregional control.

Original languageEnglish (US)
Pages (from-to)243-248
Number of pages6
JournalAnticancer research
Volume34
Issue number1
StatePublished - Jan 1 2014

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Oropharynx
Squamous Cell Carcinoma
Neck
Radiotherapy
Head
Trismus
Neoplasm Metastasis
Xerostomia
Hypopharynx
Nasopharynx
Chemoradiotherapy
Deglutition Disorders
Larynx
Retrospective Studies
Survival

Keywords

  • Metastatic unknown primary cancer squamous cell carcinoma
  • Oropharynx-targeted radiation therapy concurrent chemoradiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Mourad, W. F., Kenneth, S. H. U., Shasha, D., Concert, C., Ishihara, D. A. N., Wilson, L. I. N., ... Harrison, L. B. (2014). Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck. Anticancer research, 34(1), 243-248.

Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck. / Mourad, Waleed F.; Kenneth, S. H.U.; Shasha, Daniel; Concert, Catherine; Ishihara, D. A.N.; Wilson, L. I.N.; Shourbaji, Rania A.; Ryniak, Magdalena; Gamez, Mauricio E.; Lukens, John N.; Zujun, L. I.; Culliney, Bruce E.; Khorsandi, Azita S.; Tran, Theresa; Jacobson, Adam; Manolidis, Spiros; Schantz, Stimson; Urken, Mark; Persky, Mark S.; Harrison, Louis B.

In: Anticancer research, Vol. 34, No. 1, 01.01.2014, p. 243-248.

Research output: Contribution to journalArticle

Mourad, WF, Kenneth, SHU, Shasha, D, Concert, C, Ishihara, DAN, Wilson, LIN, Shourbaji, RA, Ryniak, M, Gamez, ME, Lukens, JN, Zujun, LI, Culliney, BE, Khorsandi, AS, Tran, T, Jacobson, A, Manolidis, S, Schantz, S, Urken, M, Persky, MS & Harrison, LB 2014, 'Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck', Anticancer research, vol. 34, no. 1, pp. 243-248.
Mourad WF, Kenneth SHU, Shasha D, Concert C, Ishihara DAN, Wilson LIN et al. Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck. Anticancer research. 2014 Jan 1;34(1):243-248.
Mourad, Waleed F. ; Kenneth, S. H.U. ; Shasha, Daniel ; Concert, Catherine ; Ishihara, D. A.N. ; Wilson, L. I.N. ; Shourbaji, Rania A. ; Ryniak, Magdalena ; Gamez, Mauricio E. ; Lukens, John N. ; Zujun, L. I. ; Culliney, Bruce E. ; Khorsandi, Azita S. ; Tran, Theresa ; Jacobson, Adam ; Manolidis, Spiros ; Schantz, Stimson ; Urken, Mark ; Persky, Mark S. ; Harrison, Louis B. / Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck. In: Anticancer research. 2014 ; Vol. 34, No. 1. pp. 243-248.
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T1 - Initial experience with oropharynx-targeted radiation therapy for metastatic squamous cell carcinoma of unknown primary of the head and neck

AU - Mourad, Waleed F.

AU - Kenneth, S. H.U.

AU - Shasha, Daniel

AU - Concert, Catherine

AU - Ishihara, D. A.N.

AU - Wilson, L. I.N.

AU - Shourbaji, Rania A.

AU - Ryniak, Magdalena

AU - Gamez, Mauricio E.

AU - Lukens, John N.

AU - Zujun, L. I.

AU - Culliney, Bruce E.

AU - Khorsandi, Azita S.

AU - Tran, Theresa

AU - Jacobson, Adam

AU - Manolidis, Spiros

AU - Schantz, Stimson

AU - Urken, Mark

AU - Persky, Mark S.

AU - Harrison, Louis B.

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N2 - Aim: Metastasis of unknown primary (MUP) is commonly treated with radiation therapy (RT) to the entire mucosal surfaces and bilateral neck nodes (LN). We report outcomes of oropharynx-targeted RT, retropharyngeal nodes (RPN) and bilateral LN in this context. Patients and Methods: Single-Institution retrospective study of 68 patients. Forty percent were treated with intensity-modulated radiation therapy (IMRT). Fifty-six percent received concurrent chemoradiotherapy (CCRT). The median age was 58 years, 82% were Caucasian, and 75% males. Stage III disease was present in 9%, stage IVA in 75% and IVB in 16%. Results: At a median follow-up of 3.5 years, the actuarial locoregional control was 95.5%. The emergence of primary developed in 1patient (1.5%) and 2patients (3%) failed in the neck. The median time-to-locoregional failure (LRF) was 18 months. Actuarial long-term RT toxicity was grade 1 xerostomia (68%), dysphagia (35%), neck stiffness (15%) and trismus (6%). Conclusion: RT to the oropharynx, RPN, and bilateral neck provides excellent oncological and functional outcomes in MUP in non-Asian patients. Sparing the mucosal surfaces of the nasopharynx, hypopharynx, and larynx seems reasonable without impacting on survival and locoregional control.

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