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Failure patterns of cervical lymph nodes in metastases of unknown origin according to target volume

Radiation Oncology Journal 2020년 38권 1호 p.18 ~ 25
Kim Dong-Yun, 허대석, 김범석, 옥찬영, 안순현, 김지훈, 정경천, 김진호, 우홍균,
소속 상세정보
 ( Kim Dong-Yun ) - Seoul National University College of Medicine Department of Radiation Oncology
허대석 ( Heo Dae-Seog ) - Seoul National University College of Medicine Department of Internal Medicine
김범석 ( Keam Bhum-Suk ) - Seoul National University College of Medicine Department of Internal Medicine
옥찬영 ( Ock Chan-Young ) - Seoul National University College of Medicine Department of Internal Medicine
안순현 ( Ahn Soon-Hyun ) - Seoul National University College of Medicine Department of Otorhinolaryngology-Head and Neck Surgery
김지훈 ( Kim Ji-Hoon ) - Seoul National University College of Medicine Department of Radiology
정경천 ( Jung Kyeong-Cheon ) - Seoul National University College of Medicine Department of Pathology
김진호 ( Kim Jin-Ho ) - Seoul National University College of Medicine Department of Radiation Oncology
우홍균 ( Wu Hong-Gyun ) - Seoul National University College of Medicine Department of Radiation Oncology

Abstract


Purpose: This study was aim to evaluate the patterns of failure according to radiotherapy (RT) target volume for cervical lymph nodes in metastases of unknown primary origin in head and neck region (HNMUO).

Materials and Methods: Sixty-two patients with HNMUO between 1998 and 2016 were retrospectively reviewed. We analyzed the clinical outcomes and primary site failure depending on the radiation target volume. The target volume was classified according to whether the potential head and neck mucosal sites were included and whether the neck node was treated involved side only or bilaterally.

Results: Potential mucosal site RT (mucosal RT) was done to 23 patients and 39 patients did not receive mucosal RT. Mucosal RT showed no significant effect on overall survival (OS) and locoregional recurrence (LRR). The location of primary site failure encountered during follow-up period was found to be unpredictable and 75% of patients with recurrence received successful salvage therapies. No significant differences in OS and LRR were found between patients treated to unilateral (n = 35) and bilateral neck irradiation (n = 21). Treatment of both necks resulted in significantly higher mucositis.

Conclusions: We found no advantages in OS and LRR of patients with HNMUO when mucosal sites and bilateral neck node were included in the radiation target volume.

키워드

Metastases of unknown primary origin in head and neck region; Pattern of failure; Radiotherapy

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