Tailored multimodality therapy guided by a two-step decision making process for head-and-neck cancer of unknown primary

There is no consensus on the treatment of head-and-neck cancer of unknown primary (HNCUP). The objective of this study is to report our single institution's experience of a tailored multimodality therapy guided by a two-step decision making process. From January 2007 to November 2013, 92 consec...

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Bibliographic Details
Published in:Oncotarget 2016-06, Vol.7 (26), p.40095-40105
Main Authors: Dou, Shengjin, Qian, Wei, Ji, Qinghai, Wang, Zhuoying, Zhu, Guopei
Format: Article
Language:English
Subjects:
Adult
Aged
China
Clinical Decision-Making
Combined Modality Therapy - methods
Disease-Free Survival
Female
Follow-Up Studies
Head and Neck Neoplasms - secondary
Head and Neck Neoplasms - therapy
Humans
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Recurrence, Local - therapy
Neoplasms, Unknown Primary
Prognosis
Radiotherapy - methods
Research Paper
Treatment Outcome
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Summary:There is no consensus on the treatment of head-and-neck cancer of unknown primary (HNCUP). The objective of this study is to report our single institution's experience of a tailored multimodality therapy guided by a two-step decision making process. From January 2007 to November 2013, 92 consecutive patients of HNCUP were treated. 77 patients were treated according the process above, 24 were treated by radiotherapy to the nasopharyngeal site, 7 received neck dissection and radiotherapy to other putative mucosal site, 30 were treated by neck dissection alone, and 16 received neck dissection followed by radiotherapy to the neck. SPSS 20.0 software was used for statistical analysis. After a median follow-up of 34 months, the 3-year overall survival rate was 84.5%. The 3-year mucosal control rate, neck control rate, distant metastasis-free survival rate and disease-free survival rate were 80.9%, 76.2%, and 92.0%, respectively. Of the 24 patients treated as putative nasopharyngeal carcinoma, no primary emerged from any site. Primary tumor emerged in 14 patients, and no primary emerged in the 31 patients treated with putative site radiation (3-year mucosal control rate: 100% vs. 67.9%, p = 0.010). Of the 46 patients treated with neck dissection with/without postoperative radiation, 14 developed neck recurrence, and patients without postoperative radiation suffered more ipsilateral neck recurrence. The two-step decision-making process seem to be reasonable in treating Chinese HNCUP patients. However, this results need to be prospectively validated.
ISSN:1949-2553
1949-2553
DOI:10.18632/oncotarget.9492