Cervical metastases from unknown primaries treated with different radiation techniques

Abstract

SUMMARY Cancer of unknown primary (CUP) syndrome presenting as metastatic lymph nodes of unknown primaries in the head and neck is a difficult clinical problem. The optimal treatment policy is not yet defined. A retrospective analysis of the clinical outcome and side effects of 41 patients with CUP syndrome treated with different irradiation techniques is given in this report. Tweny-eight patients received "involved field" irradiation confined to the involved neck and all the other patients were treated with "extended fields" including the contralateral neck and oro-and hypopharynx. The relative risk of recurrence was 30% and 56% after 1 and 3 years for patients irradiated with "involved fields" and 56% for both periods for patients treated with "extended fields." During follow-up the primary tumor was detected in 11 patients. In conclusion, after thorough diagnostic workup and surgery, limited radiotherapy to the involved neck is justified. Rudiut