Radiation Therapy in Treating Patients With Metastases to the Lymph Nodes in the Neck From an Unknown Primary Tumor
Carcinoma of Unknown Primary
About this trial
This is an interventional treatment trial for Carcinoma of Unknown Primary focused on measuring newly diagnosed carcinoma of unknown primary, squamous cell carcinoma of unknown primary
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed squamous cell carcinoma in cervical lymph node metastasis from an unknown primary tumor Histopathological grade WHO 1-3 Pathological stage N1, N2a, N2b, or N3 No N2c (i.e., bilateral metastatic nodes) No single node in supraclavicular fossa or submandibular area No evidence of primary tumor in head and neck, lung, esophageal, or other site Prior radical, radical modified, or extended radical dissection within the past 8 weeks Selective neck dissection allowed (surgeon must justify why standard procedure was not performed) No node excision alone R0 or R1 disease after dissection No distant metastases PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 OR Karnofsky 60-100% Life expectancy Not specified Hematopoietic Not specified Hepatic Not specified Renal Not specified Other Able and willing to complete quality of life questionnaires No other prior or concurrent malignancy except adequately treated basal cell skin cancer or carcinoma in situ of the cervix No psychological, familial, sociological, or geographical condition that would preclude study compliance Not pregnant or nursing Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy Concurrent chemotherapy allowed Endocrine therapy Not specified Radiotherapy Not specified Surgery See Disease Characteristics Other No other prior therapy for carcinoma of unknown primary except neck dissection
Sites / Locations
- University of Alabama at Birmingham Comprehensive Cancer Center
- Comprehensive Cancer Institute
- MBCCOP - Gulf Coast
- Montgomery Cancer Center
- DCH Cancer Treatment Center
- Foundation for Cancer Research and Education
- Providence Saint Joseph Medical Center - Burbank
- Mount Diablo Medical Center
- City of Hope Comprehensive Cancer Center
- California Cancer Center
- Saint Agnes Cancer Center
- Sutter Health Western Division Cancer Research Group
- Loma Linda University Cancer Institute at Loma Linda University Medical Center
- Veterans Affairs Medical Center - Long Beach
- USC/Norris Comprehensive Cancer Center and Hospital
- Jonsson Comprehensive Cancer Center, UCLA
- CCOP - Bay Area Tumor Institute
- Huntington Cancer Center at Huntington Hospital
- Robert and Beverly Lewis Family Cancer Care Center at Pomona Valley Hospital Medical Center
- Radiation Oncology Centers - Sacramento
- Radiation Medical Group, Incorporated
- Naval Medical Center - San Diego
- UCSF Comprehensive Cancer Center
- O'Connor Hospital
- CCOP - Santa Rosa Memorial Hospital
- St. Joseph's Regional Cancer Center
- Torrance Memorial Medical Center
- David Grant Medical Center
- Memorial Hospital Cancer Center
- University of Colorado Cancer Center at University of Colorado Health Sciences Center
- CCOP - Colorado Cancer Research Program, Incorporated
- St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
- Hospital of St. Raphael
- Yale Comprehensive Cancer Center
- CCOP - Christiana Care Health Services
- Sibley Memorial Hospital
- 21st Century Oncology - Fort Myers
- Shands Cancer Center at the University of Florida Health Science Center
- Florida Radiation Oncology Group
- Holmes Regional Medical Center
- CCOP - Mount Sinai Medical Center
- University of Miami Sylvester Cancer Center
- Baptist Hospital of Miami
- MD Anderson Cancer Center Orlando
- Bay Medical Center
- Gulf Coast Cancer Treatment Center
- Sarasota Radiation and Medical Oncology Center
- Tallahassee Memorial Hospital
- H. Lee Moffitt Cancer Center and Research Institute
- Winship Cancer Institute of Emory University
- CCOP - Atlanta Regional
- Medical Center/John B. Amos Community Cancer Center
- Regional Radiation Oncology Center at Rome
- MBCCOP - Hawaii
- Northwest Community Hospital
- Robert H. Lurie Comprehensive Cancer Center at Northwestern University
- CCOP - Central Illinois
- Ingalls Memorial Hospital
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- Lutheran General Cancer Care Center
- CCOP - Scott and White Hospital
- Methodist Medical Center of Illinois
- St. John's Cancer Center at St. John's Medical Center
- Bloomington Hospital
- Veterans Affairs Medical Center - Indianapolis (Roudebush)
- Methodist Cancer Center at Methodist Hospital
- Community Regional Cancer Care
- Oncology Institute of Greater Lafayette
- Ball Memorial Hospital Cancer Center
- CCOP - Northern Indiana CR Consortium
- Wendt Regional Cancer Center of Finley Hospital
- St. Elizabeth Medical Center
- Central Baptist Hospital
- Cancer Center at Lexington Clinic
- Markey Cancer Center at University of Kentucky Chandler Medical Center
- James Graham Brown Cancer Center at University of Louisville
- Louisville Radiation Oncology Center at Caritas Regional Cancer Center
- Merle M. Mahr Cancer Center at Regional Medical Center of Hopkins County
- Mary Bird Perkins Cancer Center
- Tulane Cancer Center at Tulane University Hospital and Clinic
- MBCCOP - LSU Health Sciences Center
- CCOP - Ochsner
- Maine Medical Center
- Anne Arundel Oncology Center
- Greenebaum Cancer Center at University of Maryland Medical Center
- Greater Baltimore Medical Center and Cancer Center
- Harbor Hospital Center
- Sinai Hospital of Baltimore
- St. Agnes Cancer Center
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Peninsula Regional Medical Center
- Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
- Cancer Research Center at Boston Medical Center
- Cape Cod Hospital
- Veterans Affairs Medical Center - Boston (Jamaica Plain)
- NSMC Cancer Center
- CCOP - Michigan Cancer Research Consortium
- University of Michigan Comprehensive Cancer Center
- Barbara Ann Karmanos Cancer Institute
- Josephine Ford Cancer Center at Henry Ford Hospital
- McLaren Regional Cancer Center
- CCOP - Kalamazoo
- Marquette General Hospital
- MidMichigan Medical Center - Midland
- CCOP - Beaumont
- William Beaumont Hospital - Royal Oak
- William Beaumont Hospital - Troy
- Fairview University Medical Center - University Campus
- Mayo Clinic Cancer Center
- CCOP - Metro-Minnesota
- Ellis Fischel Cancer Center at University of Missouri - Columbia
- CCOP - Kansas City
- St. Louis University Hospital Cancer Center
- Siteman Cancer Center
- CCOP - Cancer Research for the Ozarks
- CCOP - Montana Cancer Consortium
- CCOP - Missouri Valley Cancer Consortium
- Methodist Hospital Cancer Center at Nebraska Methodist Hospital - Omaha
- UNMC Eppley Cancer Center at the University of Nebraska Medical Center
- CCOP - Southern Nevada Cancer Research Foundation
- Comprehensive Cancer Centers of Nevada
- Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
- Elliot Regional Cancer Center
- Veterans Affairs Medical Center - East Orange
- John F. Kennedy Medical Center
- Monmouth Medical Center
- South Jersey Regional Cancer Center
- Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital
- Cancer Institute of New Jersey
- Newark Beth Israel Medical Center
- Atlantic City Medical Center
- Medical Center of Princeton
- Valley Hospital
- Community Medical Center
- Fox Chase Cancer Center at St. Francis Medical Center
- Associated Radiologists, P.A.
- Radiation Oncology Associates of Albuquerque
- Lourdes Regional Cancer Center
- SUNY Downstate Medical Center
- New York Methodist Hospital
- Finger Lakes Radiation Oncology Center
- CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
- CCOP - North Shore University Hospital
- Beth Israel Medical Center - Philipps Ambulatory Care Center
- Memorial Sloan-Kettering Cancer Center
- Herbert Irving Comprehensive Cancer Center at Columbia University
- Champlain Valley Physicians Hospital Medical Center
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- North Shore Radiation Oncology
- University Hospital at State University of New York - Upstate Medical University
- Riverhill Radiation Oncology
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
- Batte Cancer Center at Northeast Medical Center
- Leo W. Jenkins Cancer Center of University Health Systems of Eastern Carolina
- CCOP - Southeast Cancer Control Consortium
- Comprehensive Cancer Center at Wake Forest University
- Trinity Cancer Care Center
- Akron General Medical Center
- Akron City Hospital
- Cancer Center at Christ Hospital
- Charles M. Barrett Cancer Center at University Hospital
- Ireland Cancer Center
- University Hospitals of Cleveland
- Cleveland Clinic Taussig Cancer Center
- CCOP - Columbus
- Arthur G. James Cancer Hospital - Ohio State University
- CCOP - Dayton
- Parma Community General Hospital
- CCOP - Toledo Community Hospital
- Frank C. Love Cancer Institute at St. Anthony Hospital
- Oklahoma University Medical Center
- St. John Health System
- CCOP - Oklahoma
- CCOP - Columbia River Oncology Program
- Abington Memorial Hospital
- John and Dorothy Morgan Cancer Center at Lehigh Valley Hospital
- St. Luke's Hospital Cancer Center
- Geisinger Medical Center
- Mercy Fitzgerald Hospital
- Delaware County Memorial Hospital
- Dale and Frances Hughes Cancer Center
- Penn State Cancer Institute at Milton S. Hershey Medical Center
- Abramson Cancer Center at University of Pennsylvania Medical Center
- Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
- Fox Chase Cancer Center
- Albert Einstein Cancer Center
- Allegheny General Hospital
- Mercy Hospital of Pittsburgh
- Western Pennsylvania Hospital
- Hillman Cancer Center at University of Pittsburgh Cancer Institute
- Reading Hospital and Medical Center
- Mercy Hospital Cancer Center - Scranton
- Wilkes-Barre General Hospital
- CCOP - MainLine Health
- Wellspan Health - York Cancer Center
- Roger Williams Medical Center
- CCOP - Greenville
- CCOP - Upstate Carolina
- Rapid City Regional Hospital
- West Tennessee Cancer Center at Jackson-Madison County General Hospital
- Vanderbilt-Ingram Cancer Center at Vanderbilt Medical Center
- Harrington Cancer Center
- Arlington Cancer Center
- University of Texas Medical Branch
- University of Texas - MD Anderson Cancer Center
- Wilford Hall Medical Center
- Joe Arrington Cancer Research and Treatment Center
- University of Texas Health Science Center at San Antonio
- Utah Valley Regional Medical Center - Provo
- Dixie Regional Medical Center
- University of Utah Health Sciences Center
- LDS Hospital
- Green Mountain Oncology Group
- Vermont Cancer Center at University of Vermont
- Cancer Center at the University of Virginia
- RMH Regional Cancer Center
- Naval Medical Center, Portsmouth
- Bon Secours - St. Mary's Hospital
- Massey Cancer Center at Virginia Commonwealth University
- Cancer Institute at Virginia Mason Medical Center
- University Cancer Center at University of Washington Medical Center
- Deaconess Medical Center
- Yakima Valley Memorial Hospital
- Schiffler Cancer Center at Wheeling Hospital
- CCOP - St. Vincent Hospital Cancer Center, Green Bay
- St. Vincent Hospital
- Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center
- Southern Wisconsin Radiotherapy Center
- University of Wisconsin Comprehensive Cancer Center
- CCOP - Marshfield Clinic Research Foundation
- Marshfield Clinic
- Community Memorial Hospital
- Columbia Hospital
- St. Luke's Medical Center
- Veterans Affairs Medical Center - Milwaukee (Zablocki)
- All Saints Cancer Center at All Saints Healthcare
- Waukesha Memorial Hospital Regional Cancer Center
- Cliniques Universitaires Saint-Luc
- Clinique Sainte Elisabeth
- Tom Baker Cancer Center - Calgary
- Cross Cancer Institute
- Doctor Leon Richard Oncology Centre
- Saint John Regional Hospital
- Newfoundland Cancer Treatment and Research Foundation
- Nova Scotia Cancer Centre
- Margaret and Charles Juravinski Cancer Centre
- Kingston Regional Cancer Centre
- Cancer Care Ontario-London Regional Cancer Centre
- Ottawa Regional Cancer Centre
- Northeastern Ontario Regional Cancer Centre at Regional Hospital of Sudbury Regional Hospital
- Northwestern Ontario Regional Cancer Care
- Toronto Sunnybrook Regional Cancer Centre
- Princess Margaret Hospital
- CHUS-Hopital Fleurimont
- Centre Hospitalier de l'Universite de Montreal
- McGill University
- Centre Hospitalier Universitaire de Quebec
- Allan Blair Cancer Centre
- Saskatoon Cancer Centre
- Aarhus University Hospital - Aarhus Sygehus
- Vrije Universiteit Medisch Centrum
- Centre Hospitalier Universitaire Vaudois
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Selective irradiation
Extensive irradiation + ipsilaterals levels
Irradiation of the ipsilateral level I - V of the neck up to a dose of 60 Gy (30x2Gy in 6 weeks).
Irradiation on the whole mucosa of the larynx, hypopharynx, oropharynx and nasopharynx, and on both sides of the neck (levels I -V) up to a prophylactic dose of 50 Gy (25 x 2 Gy in 5 week).Irradiation of the ipsilateral level I - V of the neck should continue with an additional 10 Gy boost for a total dose of 60 Gy (30 x 2 Gy in 6 weeks).