Kamal M, et al. - In this study, researchers summarized the authors' current experience treating patients with carcinoma metastatic to the neck from an unknown primary (CUP) using intensity-modulated radiation therapy (IMRT), which principally targeted both sides of the neck, the nasopharynx, and the oropharynx. Findings revealed high rates of disease control and survival in relation to comprehensive IMRT with treatment to both sides of the neck and to the oropharyngeal and nasopharyngeal mucosa.

Methods

• Researchers performed a retrospective study by performing an institutional database search to identify patients with CUP who received IMRT.
• Frequency tabulation, survival analysis, and multivariable analysis were included in the data analysis.

Results

• Inclusion criteria was met by 260 patients.
• N2b (54%) was identified as the most common lymph node category.
• In this study, IMRT volumes included the entire pharyngolaryngeal mucosa in 78 patients, the nasopharynx and oropharynx in 167 patients, and treatment limited to the involved neck in 11 patients.
• Neck dissections were performed on 84 patients.
• Researchers noticed the 5-year overall survival, regional control, and distant metastases-free survival rates of 84%, 91%, and 94%, respectively.
• During therapy, more than 40% of patients had gastrostomy tubes, and 7% patients were diagnosed with chronic radiation-associated dysphagia.
• Worse disease-related outcomes were observed with higher lymph node burden.
• In subgroup analysis, patients with human papillomavirus-associated disease had better outcomes.
• They identified no therapeutic modality that was statistically associated with either disease-related outcomes or toxicity.