PT  - JOURNAL ARTICLE
AU  - WALEED F. MOURAD
AU  - KENNETH S. HU
AU  - DANIEL SHASHA
AU  - CATHERINE CONCERT
AU  - DAN ISHIHARA
AU  - WILSON LIN
AU  - RANIA A. SHOURBAJI
AU  - MAGDALENA RYNIAK
AU  - MAURICIO E. GAMEZ
AU  - JOHN N. LUKENS
AU  - ZUJUN LI
AU  - BRUCE E. CULLINEY
AU  - AZITA S. KHORSANDI
AU  - THERESA TRAN
AU  - ADAM JACOBSON
AU  - SPIROS MANOLIDIS
AU  - STIMSON SCHANTZ
AU  - MARK URKEN
AU  - MARK S. PERSKY
AU  - LOUIS B. HARRISON
TI  - Initial Experience with Oropharynx-targeted Radiation Therapy for Metastatic Squamous Cell Carcinoma of Unknown Primary of the Head and Neck
DP  - 2014 Jan 01
TA  - Anticancer Research
PG  - 243--248
VI  - 34
IP  - 1
4099  - http://ar.iiarjournals.org/content/34/1/243.short
4100  - http://ar.iiarjournals.org/content/34/1/243.full
SO  - Anticancer Res2014 Jan 01; 34
AB  - Aim: Metastasis of unknown primary (MUP) is commonly treated with radiation therapy (RT) to the entire mucosal surfaces and bilateral neck nodes (LN). We report outcomes of oropharynx-targeted RT, retropharyngeal nodes (RPN) and bilateral LN in this context. Patients and Methods: Single-Institution retrospective study of 68 patients. Forty percent were treated with intensity-modulated radiation therapy (IMRT). Fifty-six percent received concurrent chemoradiotherapy (CCRT). The median age was 58 years, 82% were Caucasian, and 75% males. Stage III disease was present in 9%, stage IVA in 75% and IVB in 16%. Results: At a median follow-up of 3.5 years, the actuarial locoregional control was 95.5%. The emergence of primary developed in 1patient (1.5%) and 2patients (3%) failed in the neck. The median time-to-locoregional failure (LRF) was 18 months. Actuarial long-term RT toxicity was grade 1 xerostomia (68%), dysphagia (35%), neck stiffness (15%) and trismus (6%). Conclusion: RT to the oropharynx, RPN, and bilateral neck provides excellent oncological and functional outcomes in MUP in non-Asian patients. Sparing the mucosal surfaces of the nasopharynx, hypopharynx, and larynx seems reasonable without impacting on survival and locoregional control.