Radiotherapy to the neck after neck dissection for head and neck squamous cell carcinoma from an unknown primary: A narrative review

Muhammad Shahid Iqbal; Malcolm Jackson; Claire Paterson

doi:10.1111/coa.14155

Radiotherapy to the neck after neck dissection for head and neck squamous cell carcinoma from an unknown primary: A narrative review

Clin Otolaryngol. 2024 Mar 28. doi: 10.1111/coa.14155. Online ahead of print.

Authors

Muhammad Shahid Iqbal^{1

2}, Malcolm Jackson¹, Claire Paterson³

Affiliations

¹ Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
² Department of Clinical Oncology, Newcastle University, Newcastle upon Tyne, UK.
³ Department of Clinical Oncology, The Beatson West of Scotland Cancer Centre, Glasgow, UK.

PMID: 38545823
DOI: 10.1111/coa.14155

Abstract

Purpose: To conduct a comprehensive narrative review of the evidence for radiotherapy target volumes to the neck, after neck dissection, for head and neck squamous cell carcinoma from an unknown primary (HNSCCUP). Inclusion or exclusion of mucosal irradiation is not the focus of interest for this review article.

Materials and methods: Literature (PubMed-Medline, EMBASE database and Cochrane library) was searched using the relevant keywords. The search results were limited to the studies published in year 2000 or after.

Results: Eight studies met the inclusion criteria. All studies were retrospective in nature. The incidence of contralateral recurrence rates in the untreated neck when the involved neck only is treated remains very low (0%-10%). Survival has improved over the past two decades, most likely due to improved diagnostic techniques and the increase in incidence of HPV-related disease.

Conclusion: Given the rarity of disease, level one evidence from randomised controlled trials is lacking. Available data are retrospective but support unilateral post-operative radiotherapy as a treatment option in selected cases.

Keywords: head and neck cancer; human papillomavirus; unilateral radiotherapy; unknown primary.

Publication types

Review