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Title: Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis

Abstract

Objectives: Carcinoma of unknown primary (CUP) in the abdomen and pelvis is a heterogeneous group of cancers with no standard treatment. Considered by many to be incurable, these patients are often treated with chemotherapy alone. In this study, we determined the effectiveness of radiation therapy in combination with chemotherapy in patients with CUP in the abdomen and pelvis. Patients and Methods: Medical records were reviewed for 37 patients with CUP treated with radiation therapy for disease located in the soft tissues and/or nodal basins of the abdomen and pelvis at University of Texas M.D. Anderson Cancer between 2002 and 2009. All patients underwent chemotherapy, either before or concurrent with radiation therapy. Patients were selected for radiation therapy on the basis of histologic type, disease extent, and prior therapy response. Twenty patients underwent definitive radiation therapy (defined as radiation therapy targeting all known disease sites with at least 45 Gy) and 17 patients underwent palliative radiation therapy. Only 6 patients had surgical resection of their disease. Patient and treatment characteristics were extracted and the endpoints of local disease control, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity incidence were analyzed. Results: The 2-year PFS and OS rates for the entiremore » cohort were 32% and 57%, respectively. However, in patients treated with definitive radiation therapy, the rates were 48% and 76%, and 7 patients lived more than 3 years after treatment with no evidence of disease progression. Nevertheless, radiation-associated toxicity was significant in this cohort, as 40% experienced Grade 2 or higher late toxicities. Conclusions: The use of definitive radiation therapy should be considered in selected patients with CUP in the soft tissues or nodal basins of the abdomen and pelvis.« less

Authors:
;  [1];  [2]; ; ; ; ;  [1]
  1. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States)
  2. Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
22056270
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 82; Journal Issue: 5; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABDOMEN; CARCINOMAS; CHEMOTHERAPY; LYMPH NODES; MEDICAL RECORDS; METASTASES; PATIENTS; PELVIS; RADIOTHERAPY; SURGERY; TOXICITY

Citation Formats

Kelly, Patrick, Das, Prajnan, Varadhachary, Gauri R, Fontanilla, Hiral P, Krishnan, Sunil, Delclos, Marc E, Jhingran, Anuja, Eifel, Patricia J, and Crane, Christopher H., E-mail: ccrane@mdanderson.org. Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.03.051.
Kelly, Patrick, Das, Prajnan, Varadhachary, Gauri R, Fontanilla, Hiral P, Krishnan, Sunil, Delclos, Marc E, Jhingran, Anuja, Eifel, Patricia J, & Crane, Christopher H., E-mail: ccrane@mdanderson.org. Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis. United States. https://doi.org/10.1016/J.IJROBP.2011.03.051
Kelly, Patrick, Das, Prajnan, Varadhachary, Gauri R, Fontanilla, Hiral P, Krishnan, Sunil, Delclos, Marc E, Jhingran, Anuja, Eifel, Patricia J, and Crane, Christopher H., E-mail: ccrane@mdanderson.org. 2012. "Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis". United States. https://doi.org/10.1016/J.IJROBP.2011.03.051.
@article{osti_22056270,
title = {Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis},
author = {Kelly, Patrick and Das, Prajnan and Varadhachary, Gauri R and Fontanilla, Hiral P and Krishnan, Sunil and Delclos, Marc E and Jhingran, Anuja and Eifel, Patricia J and Crane, Christopher H., E-mail: ccrane@mdanderson.org},
abstractNote = {Objectives: Carcinoma of unknown primary (CUP) in the abdomen and pelvis is a heterogeneous group of cancers with no standard treatment. Considered by many to be incurable, these patients are often treated with chemotherapy alone. In this study, we determined the effectiveness of radiation therapy in combination with chemotherapy in patients with CUP in the abdomen and pelvis. Patients and Methods: Medical records were reviewed for 37 patients with CUP treated with radiation therapy for disease located in the soft tissues and/or nodal basins of the abdomen and pelvis at University of Texas M.D. Anderson Cancer between 2002 and 2009. All patients underwent chemotherapy, either before or concurrent with radiation therapy. Patients were selected for radiation therapy on the basis of histologic type, disease extent, and prior therapy response. Twenty patients underwent definitive radiation therapy (defined as radiation therapy targeting all known disease sites with at least 45 Gy) and 17 patients underwent palliative radiation therapy. Only 6 patients had surgical resection of their disease. Patient and treatment characteristics were extracted and the endpoints of local disease control, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity incidence were analyzed. Results: The 2-year PFS and OS rates for the entire cohort were 32% and 57%, respectively. However, in patients treated with definitive radiation therapy, the rates were 48% and 76%, and 7 patients lived more than 3 years after treatment with no evidence of disease progression. Nevertheless, radiation-associated toxicity was significant in this cohort, as 40% experienced Grade 2 or higher late toxicities. Conclusions: The use of definitive radiation therapy should be considered in selected patients with CUP in the soft tissues or nodal basins of the abdomen and pelvis.},
doi = {10.1016/J.IJROBP.2011.03.051},
url = {https://www.osti.gov/biblio/22056270}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 82,
place = {United States},
year = {Sun Apr 01 00:00:00 EDT 2012},
month = {Sun Apr 01 00:00:00 EDT 2012}
}