Bilateral vs ipsilateral adjuvant radiotherapy in patients with cancer of unknown primary of the head and neck: An analysis of the clinical outcome and radiation-induced side effects

Head Neck. 2019 Jun;41(6):1785-1794. doi: 10.1002/hed.25637. Epub 2019 Jan 19.

Abstract

Background: The purpose of this study was to analyze and compare ipsilateral and bilateral adjuvant radiotherapy in patients with cancer of unknown primary (CUP) of the head and neck.

Methods: Overall survival, recurrence-free survival, and radiation-induced side effects were assessed in 76 patients with CUP who underwent ipsilateral (n = 29) or bilateral (n = 47) radiotherapy.

Results: At a median follow-up of 41 months, the 5-year overall survival and recurrence-free rate were 67.9% and 71.5%, respectively. No statistically significant difference between ipsilateral and bilateral radiotherapy could be found regarding 5-year overall survival, recurrence-free survival, occurrence of a primary tumor, and distant metastasis. The analysis of radiation-induced acute side effects showed a significant benefit of ipsilateral radiotherapy.

Conclusion: As the main parameters of the study regarding the outcome and radiation-induced side effects showed no advantages of bilateral radiotherapy, the strategy of ipsilateral radiotherapy can be recommended for the adjuvant treatment of CUP patients.

Keywords: carcinoma of unknown primary; cervival lymph node metastases; ipsilateral vs bilateral radiotherapy; radiotherapy strategies; treatment outcome.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / radiotherapy*
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms, Unknown Primary / mortality
  • Neoplasms, Unknown Primary / pathology
  • Neoplasms, Unknown Primary / radiotherapy*
  • Radiotherapy, Adjuvant
  • Survival Rate
  • Treatment Outcome