{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:58:26Z","timestamp":1781179106696,"version":"3.54.1"},"reference-count":23,"publisher":"Scientific Scholar","issue":"02","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["South Asian J Cancer"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report the patterns of failure and survival with carcinoma of unknown primary of the head and neck (CUP-HN).<\/jats:p>\n                  <jats:p>This is a retrospective audit of CUP-HN patients treated with curative radiotherapy (RT) between January 2006 and December 2020. All patients received RT to the neck\u2014definitive RT (DRT) or surgery (Sx)\u2009+\u2009adjuvant RT (ART),\u2009\u00b1\u2009chemotherapy.<\/jats:p>\n                  <jats:p>Of the 108 eligible patients, 81 (75%) used tobacco. Positron emission tomography with computed tomography was performed in 102 patients (94.4%). Seventy-five patients (69.4%) were treated with DRT\u2009\u00b1\u2009chemotherapy, while 33 (30.6%) underwent Sx\u2009+\u2009ART\u2009\u00b1\u2009chemotherapy. Median lymph node size was significantly different between DRT and ART groups (5 vs. 3.5cm, p\u2009=\u20090.001). At a median follow-up of 60 months, 35.1% patients had a neck failure (within treatment portal 37, outside portal 1). Nine patients (8.3%) developed 10 sites of subsequent mucosal primary (SMP)\u2014all occurred in the oral cavity, six of whom had received comprehensive mucosal irradiation (CMI). Three-year survival outcomes were significantly better with Sx\u2009+\u2009ART compared to DRT (local control in neck: 96.8\u2009\u00b1\u20093.2 vs. 50.6\u2009\u00b1\u20096.2, p\u2009&lt;\u20090.001, locoregional control: 89.7\u2009\u00b1\u20095.7 vs. 48.6\u2009\u00b1\u20096.3, p\u2009&lt;\u20090.001), progression-free survival: 80.7\u2009\u00b1\u20097.1 vs. 38.7\u2009\u00b1\u20096, p\u2009&lt;\u20090.001, and overall survival [OS]: 67.2\u2009\u00b1\u20098.5 vs. 41.9\u2009\u00b1\u20096.2, p\u2009=\u20090.01), respectively. After propensity score matching, all survival outcomes (except OS) were better with Sx\u2009+\u2009ART compared to DRT.<\/jats:p>\n                  <jats:p>All SMPs developed in the oral cavity in this tobacco-driven population. Inclusion of oral cavity for CMI may be considered in tobacco-driven populations; however, this has to be weighed against the toxicity involved.<\/jats:p>","DOI":"10.1055\/s-0045-1806744","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T19:46:05Z","timestamp":1743450365000},"page":"352-359","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of Failure in Head and Neck Carcinoma of Unknown Primary: Insights from a Tobacco-Associated Cancer Cohort"],"prefix":"10.25259","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0744-4838","authenticated-orcid":false,"given":"Sarbani Ghosh","family":"Laskar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, Maharashtra, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jifmi Jose","family":"Manjali","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, Maharashtra, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwini","family":"Budrukkar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, Maharashtra, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monali","family":"Swain","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, Maharashtra, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, 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