Radiotherapeutic Management of Cervical Lymph Node Metastases From an Unknown Primary Site

Abstract

IPSI radiation therapy demonstrated excellent locoregional control with no adverse effect on disease-free survival or overall survival.

Is bilateral radiotherapy necessary for patients with unilateral squamous cell carcinoma of unknown primary of the head and neck region?

“…No significant difference in OS was observed between bilaterally and unilaterally irradiated patients. This result is consistent with data from the literature where no OS benefit was shown for either group [8] , [9] , [10] , [26] , [27] , [28] , [29] . We furthermore found no difference in local control between unilaterally and bilaterally irradiated patients, consistent with recent studies [5] , [8] , [9] , [27] , [30] .…”

“…This result is consistent with data from the literature where no OS benefit was shown for either group [8] , [9] , [10] , [26] , [27] , [28] , [29] . We furthermore found no difference in local control between unilaterally and bilaterally irradiated patients, consistent with recent studies [5] , [8] , [9] , [27] , [30] . Two older studies showed a benefit in favor of bilateral irradiation in a patient population treated with 2D/3D irradiation techniques [6] , [26] .…”

“…We found that local recurrences occurred in all cases on the initially affected side of the neck, and in 85 % in the former CTV. This is comparable to other studies showing none [31] , [32] , [33] , [34] , [35] or only a single [10] , [27] , [36] contralateral recurrence among the unilaterally irradiated patients. Some older cohorts form the 2D era describe higher rates of contralateral recurrences from 10 % up to 15.6 % [8] , [26] , [37] .…”

Evaluation of radiation treatment volumes for unknown primaries of the head and neck in the era of FDG PET

“…reported no oncologic benefit to bilateral neck irradiation as well. [9] Our results are consistent with other published reports [10][11][12][13].…”

Management of unilateral head and neck carcinoma of unknown primary: Retrospective analysis of the impact of postoperative radiotherapy target volumes

“…Overall, the locoregional relapse rate did not statistically differ between unilateral neck irradiation (17%) and comprehensive radiotherapy (28%). These results are comparable to those of recent studies with neck relapse rate ranging from 6% to 22% after unilateral radiotherapy and 0% to 31% after comprehensive radiotherapy …”