What 2 cover.
What mucosal sites should be covered when treating head and neck squamous cell carcinoma of unknown primary (SCCUP)? Most cover some combination of the nasopharynx, oropharynx, hypopharynx, and larynx depending on node levels involved and molecular features (i.e. HPV or EBV). Recent ASCO guidelines for SCCUP advocate for more limited mucosal coverage typically focusing on the oropharynx. Since the late 90’s, patients treated at University of Florida with SCCUP and primarily level IIA (N1-N2) nodal involvement had coverage of the nasopharynx and oropharynx without coverage of the hypopharynx or larynx. Among 50 patients treated with this approach, none developed mucosal recurrence while 2% had neck/distant recurrence and another 2% had distant-only recurrence. | De Leo, Pract Radiat Oncol 2021