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Radiation therapy of CUP

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).

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