Open AccessTreatment of head and neck carcinoma of unknown primary: Cracking a nut with a sledgehammer?
Author(s) -
Berzenji Diako,
Monserez Dominiek A.,
Verduijn Gerda M.,
Dronkers Emilie A.C.,
Jansen Peter P.,
Keereweer Stijn,
Sewnaik Aniel,
Baatenburg de Jong Robert J.,
Hardillo Jose A.
Publication year - 2021
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.539
Subject(s) - medicine , retrospective cohort study , radiation therapy , neck dissection , toxicity , surgery , head and neck squamous cell carcinoma , cohort , head and neck cancer , basal cell , carcinoma
Abstract Objectives To compare the impact on survival and late radiation toxicity of patients with squamous cell carcinoma of unknown primary who were treated with ipsilateral neck dissection and ipsilateral postoperative radiotherapy (PORT) and patients treated with ipsilateral neck dissection and PORT to both sides of the neck plus the pharyngeal axis. Methods Retrospective cohort study performed at the Erasmus University Medical Center in which 78 patients with squamous cell carcinoma of unknown primary were identified. Thirty‐nine patients received PORT to both sides of the neck plus the pharyngeal axis (BILAX) and another 39 patients were irradiated on the ipsilateral neck (IPSI) only. The endpoints of the present study were 3‐year overall survival (OS), 3‐year disease‐free survival (DFS), and overall late radiation toxicity. Results The 3‐year OS rate of the entire group of 78 patients was 74.2% and the 3‐year DFS rate was 72.7%. The 3‐year OS rates for the IPSI and the BILAX groups were 74.4% and 74.1%, respectively ( P = .654). The most common late radiation toxicity experienced was xerostomia (64.8%), which was significantly more often seen in the BILAX group than in the IPSI group (83.8% and 44.1%, respectively, P = .001). Overall late radiation toxicity was significantly higher in the BILAX group ( P = .003). Conclusion There was no significant difference in OS and DFS rates between the IPSI and the BILAX group. Late radiation toxicity was significantly higher in the BILAX group. Level of Evidence Level 2b: Individual retrospective cohort study.