CUP in the head/neck area is treated with radiation therapy as for primary head/neck cancer and may cure the disease. The epipharynx is always included in the radiation field.
Palliative radiation therapy is otherwise appropriate for symptom-causing metastases and is normally given as a single fraction of 8 Gy, or fractionated over two weeks as 3 Gy x 10.
The goal of treatment is:
- pain management
- local control
- fracture prevention
- prevention of neurological symptoms
Stereotactic radiation treatment (15-25 Gy x 1) to the brain is appropriate for 1-3 brain metastases of greatest diameter < 4 cm.
Radiation therapy should be fractionated depending on expected survival time, localization, field size, and assumed diagnosis (assumed radiosensitivity).