Strojan Primož, Kokalj Marko, Zadnik Vesna, Aničin Aleksandar, Plavc Gaber, Didanović Vojislav, Šifrer Robert, Lanišnik Boštjan
Department of Radiation Oncology, Institute of Oncology, Zaloška 2, 1000, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4561-4569. doi: 10.1007/s00405-016-4172-5. Epub 2016 Jun 30.
In patients with squamous cell carcinoma (SCC) metastases to neck lymph nodes and unknown primary tumor, the role of elective irradiation of uninvolved neck and potential mucosal primary sites is yet to be determined. The aim of this study was to review the experience treating SCC of unknown primary metastatic to neck nodes with surgery and postoperative radiotherapy (PORT) in Slovenia between 1995 and 2010 and to determine the importance of the extent of irradiated volume. For this purpose, the nationwide Cancer Registry of Slovenia database was used for identifying patients. 126 patients were identified. Involved-field PORT and extended-field PORT was used in 50 and 76 patients, respectively. At 5 years, locoregional control was 86 %, disease-specific survival 77 %, and overall survival 57 %. In multivariate analysis, the extent of irradiated volume has not been predictive for any outcome under study. Grade ≥3 acute and late radiotherapy-induced toxicities were more frequent in the extended-field PORT group. In conclusion, although not superior, involved-field PORT seems to be a preferred treatment option in SCC of unknown primary metastatic to neck nodes due to significantly reduced toxicity and better prospects for successful salvage.
对于颈部淋巴结转移且原发肿瘤不明的鳞状细胞癌（SCC）患者，对未受累颈部及潜在黏膜原发部位进行选择性放疗的作用尚待确定。本研究的目的是回顾1995年至2010年期间斯洛文尼亚采用手术及术后放疗（PORT）治疗颈部淋巴结转移但原发灶不明的SCC的经验，并确定照射范围的重要性。为此，使用了斯洛文尼亚全国癌症登记数据库来识别患者。共识别出126例患者。分别有50例和76例患者采用了受累野PORT和扩大野PORT。5年时，局部区域控制率为86%，疾病特异性生存率为77%，总生存率为57%。在多变量分析中，照射范围对所研究的任何结局均无预测作用。扩大野PORT组中≥3级急性和晚期放疗所致毒性反应更为常见。总之，尽管受累野PORT并不优于扩大野PORT，但由于毒性显著降低且成功挽救的前景更好，受累野PORT似乎是颈部淋巴结转移但原发灶不明的SCC的首选治疗方案。
