title: Induction docetaxel-cisplatin followed by extended-field radiotherapy in patients with cervical metastases from unknown primary carcinoma.
abstract: BACKGROUND
  Cervical metastases from unknown primary tumors are rare and no clear therapeutic options are available. This retrospective analysis aimed to evaluate toxicity and activity of a sequential chemoradiation regimen consisting of induction chemotherapy followed by extended-field radiotherapy in patients with cervical metastases from unknown primary tumors.
  
  
  METHODS
  Patients with cytological or histological diagnosis of latero-cervical lymph-node metastasis from carcinoma with unknown origin treated with sequential chemotherapy (3 cycles of docetaxel and cisplatin, each administered as intravenous infusion at the dose of 75 mg/m(2) on day 1, every 21 days) and radiotherapy (cumulative dose of 70 Gy) were included in this study. The radiological response was assessed by central review according to the revised RECIST criteria.
  
  
  RESULTS
  Fifteen patients received three cycles of induction chemotherapy with the combination of docetaxel and cisplatin. Patients were subsequently treated with extended-field radiotherapy. Three complete responses were observed after induction chemotherapy and 13 after the chemoradiation treatment. The overall response rate after chemoradiation, was 93.3% (14 of 15 evaluable patients). One year disease-free-survival was 83.3% (10 of 12 evaluable patients). Treatment was well-tolerated; two cases of grade 4 neutropenia, two of grade 3 mucositis and eight of grade 2 nausea were the worst, most clinically-relevant side-effects.
  
  
  CONCLUSIONS
  Induction chemotherapy followed by extended-field radiotherapy showed good activity and manageable toxicity in patients with cervical metastases from unknown primary tumors.
authors.affiliation: National Tumor Institute of Naples-Head and Neck Medical Oncology Unit Via Mariano Semmola 80131 Naples, Italy. francesco.perri80@alice.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Perri
authors.forename: Franco
authors.initials: F
authors.lastname: Ionna
authors.forename: Paolo
authors.initials: P
authors.lastname: Muto
authors.forename: Carlo
authors.initials: C
authors.lastname: Buonerba
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Della Vittoria Scarpati
authors.forename: Davide
authors.initials: D
authors.lastname: Bosso
authors.forename: Franco
authors.initials: F
authors.lastname: Fulciniti
authors.forename: Antonio
authors.initials: A
authors.lastname: Daponte
authors.forename: Angela
authors.initials: A
authors.lastname: Argenone
authors.forename: Fabio
authors.initials: F
authors.lastname: Sandomenico
authors.forename: Giuseppe
authors.initials: G
authors.lastname: DI Lorenzo
authors.forename: Francesco
authors.initials: F
authors.lastname: Caponigro
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D009382:Neoplasms, Unknown Primary / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin