Tags

Type your tag names separated by a space and hit enter

Intensity-modulated radiotherapy for cervical node squamous cell carcinoma metastases from unknown head-and-neck primary site: M. D. Anderson Cancer Center outcomes and patterns of failure.
Int J Radiat Oncol Biol Phys. 2010 Nov 15; 78(4):1005-10.IJ

Abstract

PURPOSE

Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center.

METHODS AND MATERIALS

We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and the survival rates calculated using the Kaplan-Meier method.

RESULTS

Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients.

CONCLUSION

The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon.

Authors+Show Affiliations

Department of Radiation Oncology, University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA. sjfrank@mdanderson.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

20207504

Citation

Frank, Steven J., et al. "Intensity-modulated Radiotherapy for Cervical Node Squamous Cell Carcinoma Metastases From Unknown Head-and-neck Primary Site: M. D. Anderson Cancer Center Outcomes and Patterns of Failure." International Journal of Radiation Oncology, Biology, Physics, vol. 78, no. 4, 2010, pp. 1005-10.
Frank SJ, Rosenthal DI, Petsuksiri J, et al. Intensity-modulated radiotherapy for cervical node squamous cell carcinoma metastases from unknown head-and-neck primary site: M. D. Anderson Cancer Center outcomes and patterns of failure. Int J Radiat Oncol Biol Phys. 2010;78(4):1005-10.
Frank, S. J., Rosenthal, D. I., Petsuksiri, J., Ang, K. K., Morrison, W. H., Weber, R. S., Glisson, B. S., Chao, K. S., Schwartz, D. L., Chronowski, G. M., El-Naggar, A. K., & Garden, A. S. (2010). Intensity-modulated radiotherapy for cervical node squamous cell carcinoma metastases from unknown head-and-neck primary site: M. D. Anderson Cancer Center outcomes and patterns of failure. International Journal of Radiation Oncology, Biology, Physics, 78(4), 1005-10. https://doi.org/10.1016/j.ijrobp.2009.09.006
Frank SJ, et al. Intensity-modulated Radiotherapy for Cervical Node Squamous Cell Carcinoma Metastases From Unknown Head-and-neck Primary Site: M. D. Anderson Cancer Center Outcomes and Patterns of Failure. Int J Radiat Oncol Biol Phys. 2010 Nov 15;78(4):1005-10. PubMed PMID: 20207504.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intensity-modulated radiotherapy for cervical node squamous cell carcinoma metastases from unknown head-and-neck primary site: M. D. Anderson Cancer Center outcomes and patterns of failure. AU - Frank,Steven J, AU - Rosenthal,David I, AU - Petsuksiri,Janjira, AU - Ang,K Kian, AU - Morrison,William H, AU - Weber,Randal S, AU - Glisson,Bonnie S, AU - Chao,K S Clifford, AU - Schwartz,David L, AU - Chronowski,Gregory M, AU - El-Naggar,Adel K, AU - Garden,Adam S, Y1 - 2010/03/06/ PY - 2009/06/24/received PY - 2009/08/14/revised PY - 2009/09/09/accepted PY - 2010/3/9/entrez PY - 2010/3/9/pubmed PY - 2010/11/11/medline SP - 1005 EP - 10 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 78 IS - 4 N2 - PURPOSE: Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center. METHODS AND MATERIALS: We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and the survival rates calculated using the Kaplan-Meier method. RESULTS: Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients. CONCLUSION: The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon. SN - 1879-355X UR - https://www.unboundmedicine.com/medline/citation/20207504/Intensity_modulated_radiotherapy_for_cervical_node_squamous_cell_carcinoma_metastases_from_unknown_head_and_neck_primary_site:_M__D__Anderson_Cancer_Center_outcomes_and_patterns_of_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(09)03108-3 DB - PRIME DP - Unbound Medicine ER -