Volumes cibles en radiothérapie des adénopathies cervicales de primitif inconnu : état des lieux et pistes vers une approche sélective raisonnée sous l’égide du Refcor (Réseau d’expertise français des cancers ORL rares)

摘要: The treatment of carcinomas unknown primary revealed by cervical lymphadenopathy is based on neck dissection and nodal pan-mucosal irradiation to control the avoid emergence a metachronous primary. aim this review was assess diagnostic therapeutic approaches criteria that may be used for customized selective approach severe toxicities irradiation. A literature search performed with following keywords: lymphadenopathy, primary, upper aerodigestive tract, cancer, radiotherapy, squamous cell carcinoma, variants. workup includes head scanner or MRI, ((18)F)-FDG PET CT, panendoscopy tonsillectomy. Squamous carcinoma represents over two thirds cases. number metastatic nodes, level, histological variant (associated HPV/EBV status) determine site origin might weighted determination radiation target volumes multidisciplinary basis. relevant decrease toxicity only if mucosal not impaired. Although no recommendation can yet made in absence sufficient level evidence, relevance systematic appears questionable clinical situations. Accordingly, redefinition discussed prospectively evaluated relation index obtained.