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Oropharynx‐directed ipsilateral irradiation for p16‐positive squamous cell carcinoma involving the cervical lymph nodes of unknown primary origin
Author(s) -
Chen Allen M.,
Meshman Jessica,
Hsu Sophia,
Yoshizaki Taeko,
Abemayor Elliot,
John Maie St.
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24906
Subject(s) - medicine , cervical lymph nodes , radiation therapy , basal cell , lymph , primary tumor , chemotherapy , cisplatin , oncology , surgery , radiology , gastroenterology , pathology , cancer , metastasis
Background The purpose of this study was to present our findings on the use of limited‐field, oropharynx‐directed ipsilateral irradiation for p16‐positive squamous cell carcinoma of unknown primary origin. Methods Between April 2011 and January 2016, 25 patients with a histological diagnosis of p16‐positive squamous cell carcinoma were selectively irradiated to the ipsilateral oropharynx and cervical neck for tumors of unknown primary origin. The dose to the oropharynx ranged from 54‐60 Gy (median 60 Gy) in 30‐33 fractions. Concurrent cisplatin‐based chemotherapy was administered to 8 patients (32%). Results The actuarial 2‐year estimates of locoregional control, progression‐free survival, and overall survival were 91%, 87%, and 92%, respectively. One patient failed in the contralateral neck. There was no grade 3 + toxicity in either the acute or late setting. Conclusion Oropharynx‐directed, ipsilateral radiation results in disease control that compares favorably with historical controls treated by comprehensive mucosal and bilateral neck radiation.