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Retrospective analysis of definitive radiotherapy for neck node metastasis from unknown primary tumor: Japanese Radiation Oncology Study Group study

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Title: Retrospective analysis of definitive radiotherapy for neck node metastasis from unknown primary tumor: Japanese Radiation Oncology Study Group study
Authors: Yamazaki, Takuya / Kodaira, Takeshi / Ota, Yosuke / Akimoto, Tetsuo / Wada, Hitoshi / Hiratsuka, Junichi / Nishimura, Yasumasa / Ishihara, Shunichi / Nonoshita, Takeshi / Hayakawa, Kazushige / Sekii, Shuhei / Uchida, Nobue
Issue Date: 1-Sep-2017
Publisher: Oxford University Press
Citation: Japanese Journal of Clinical Oncology, 47(9), pp.856-862; 2017
Abstract: Objective: To investigate the optimal treatment method and risk factor of neck node metastasis from unknown primary tumors (NUP) treated by radiotherapy. Methods: Retrospective case study based on a multi-institutional survey was conducted by the Japanese Radiation Oncology Study Group. Patients pathologically diagnosed as having NUP from 1998 to 2007 were identified. Univariate and multivariate analyses of overall survival (OS), progression free survival (PFS), neck progression free survival (NPFS) and mucosal progression free survival (MPFS) were evaluated. Results: In total, 130 patients with median age of 65 years were included. Nodal stages N1, N2a, N2b and N2c were observed for 10, 26, 43, 12 and 39 patients, respectively. All the patients received radiotherapy (RT) with neck dissection in 60 and with chemotherapy in 67 cases. The median doses to the metastatic nodes, prophylactic neck and prophylactic mucosal sites were 60.0, 50.4 and 50.4 Gy, respectively. The median follow-up period for surviving patients was 42 months. Among 12 patients, occult primary tumors in the neck region developed after radiotherapy. The 5-year OS, PFS, NPFS and MPFS were 58.1%, 42.4%, 47.3% and 54.9%, respectively. Univariate analysis showed that lower N stage (N1–2b), non-bulky node (<6 cm) and negative extracapsular extension (ECE) status were the factors associated with favorable OS, PFS, NPFS and MPFS. Radical surgery proved to be a favorable factor of OS, NPFS and MPFS. On multivariate analysis, lower N stage and negative ECE status were correlated with improved survival. Conclusions: Lower nodal stage and negative ECE status showed a favorable impact on survival and disease control in patients with NUP treated by radiotherapy.
Keywords: unknown primary tumors / head and neck cancer / radiotherapy
URI: http://hdl.handle.net/10069/37928
ISSN: 03682811
DOI: 10.1093/jjco/hyx093
Rights: © The Author 2017. Published by Oxford University Press. / This is a pre-copyedited, author-produced PDF of an article accepted for publication in Japanese Journal of Clinical Oncology following peer review. The version of record Japanese Journal of Clinical Oncology, 47(9), pp.856-862; 2017 is available online at: http://dx.doi.org/10.1093/jjco/hyx093
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/37928

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