Abstract：
BACKGROUND: The term metastatic carcinoma to cervical lymph nodes from an unknown primary includes a small group of tumors that present themselves with metastases to the cervical nodes, and in which diagnostic methods do not reveal the primary source of these metastases. Histologically, in most cases, these are metastases of squamous cell carcinoma. Carcinomas of unknown primary metastatic to cervical nodes account for < 5% of carcinomas of unknown primary and < 5% of head and neck cancers. The optimal treatment has not yet been defined. In the absence of distant metastases, the intention of treatment is curative. Patients are treated mostly with combined approaches including surgery, radiotherapy, or concomitant chemoradiotherapy. Radiotherapy is part of the treatment algorithm in most of the referenced works and includes irradiation of the mucosal sites of the pharyngeal axis as a potential localization of the primary tumor and unilateral or, more often, bilateral irradiation of the neck. Due to the higher risk of late toxicities observed, individualization of irradiated volumes based on the extent of the disease or other clinical parameters is a rational way to reduce these risks. Purpose: The presented work discusses the treatment options for patients with metastatic carcinoma to cervical lymph nodes from an unknown primary. Furthermore, the work reports on the high effectiveness of curative radiotherapy in this group of tumors.
摘要：
背景：术语“从未知原发灶转移到颈淋巴结的转移癌”包括一小组肿瘤，这些肿瘤本身转移到颈淋巴结，并且其中诊断方法不能揭示这些转移的主要来源。组织学上,在大多数情况下,这些是鳞状细胞癌的转移。颈淋巴结转移不明的原发癌占原发癌的5%和头颈部癌的5%。尚未确定最佳治疗方法。在没有远处转移的情况下，治疗的意图是治愈的。患者大多采用包括手术在内的联合方法治疗，放射治疗,或伴随放化疗。放射治疗是大多数参考作品中治疗算法的一部分，包括咽轴粘膜部位的照射，作为原发性肿瘤的潜在定位，更多的时候,颈部的双侧照射。由于观察到晚期毒性的风险较高，根据疾病程度或其他临床参数对照射量进行个体化是降低这些风险的合理方法.目的：所提出的工作讨论了从不明原发灶转移到颈淋巴结的转移性癌患者的治疗选择。此外，该工作报告了该组肿瘤的根治性放射治疗的高效性。
