Ipsilateral Radiotherapy for Cervical Lymph Node Metastases


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Ipsilateral neck–only radiation therapy “demonstrated excellent locoregional control with no adverse effect on disease-free survival or overall survival” among patients with cervical metastases from an unknown primary site, according to a retrospective review of medical records from 46 patients treated at an academic tertiary care hospital for cervical metastases from an unknown primary site.

“All patients were treated with radiation therapy. Radiotherapy target volumes were categorized as either ipsilateral neck only or comprehensive, including both the potential mucosal surfaces and ipsilateral or bilateral neck,” reported the reviewers in the Archives of Otolaryngology—Head and Neck Surgery.1 They found no differences in overall survival with either category of radiation therapy.

Overall survival was 87% at 2 years and 77% at 5 years. Cause-specific survival was 89% at 2 years and 81% at 5 years. “There were no ipsilateral neck failures,” the authors reported. “There was no difference in overall survival between patients treated with [ipsilateral neck only] or [comprehensive] radiation therapy. The contralateral neck was controlled in all patients receiving bilateral neck irradiation and in 95% receiving ipsilateral neck irradiation.”

Human papillomavirus status, as determined by p16 immunohistochemical analysis was evaluated for 34 patients, and results for 16 (47%) were positive. “There was a nonsignificant trend toward improved overall survival in p16-positive patients (P = .06).” the authors noted. ■

Reference

1. Perkins SM, Spencer CR, Chernock RD, et al: Radiotherapeutic management of cervical lymph node metastases from an unknown primary site. Arch Otolaryngol Head Neck Surg 138:656-661, 2001.



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