Oral oncology · 2017
Five-year outcomes of an oropharynx-directed treatment approach for unknown primary of the head and neck.
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Hu Kenneth Shung, Mourad Waleed Fouad, Gamez Mauricio E, Lin Wilson, Jacobson Adam Saul, Persky Mark Stephen, Urken Mark L, Culliney Bruce E, Li Zujun, Tran Theresa Nguyen, Schantz Stimson Pryor, Chadha Juskaran, Harrison Louis Benjamin
Аннотация
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 54months, 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 5year 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.
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 54months, 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 5year 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.
Предметные рубрики MeSH
AdultAgedAged, 80 and overCarcinoma, Squamous CellCombined Modality TherapyFemaleHumansMaleMiddle AgedMultimodal ImagingNeoplasms, Unknown PrimaryOropharyngeal NeoplasmsPositron-Emission TomographyRadiotherapy, Intensity-ModulatedSurvival AnalysisTomography, X-Ray ComputedTreatment OutcomeYoung Adult