Comparable Outcomes Without Routine Pan-mucosal Irradiation in Head and Neck Carcinoma of Unknown Primary.

Mahmoud Allaf, Linda Diederich, André Buchali, Heidi Olze, Carmen Stromberger, Achim Franzen, Annekatrin Coordes

Abstract read

In one paragraph

Article in Advances in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

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0citing papers in PubMed

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mahmoud AllafDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Ruppin Brandenburg (ukrb), Brandenburg Medical School, Neuruppin, Germany.

Linda DiederichCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Otorhinolaryngology, Head and Neck Surgery, Campus Benjamin Franklin, Berlin, Germany.

André BuchaliFaculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany.

Heidi OlzeCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Otorhinolaryngology, Head and Neck Surgery, Campus Virchow Klinikum and Campus Charité Mitte, Berlin, Germany.

Carmen StrombergerCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiooncology, Campus Virchow Klinikum, Berlin, Germany.

Achim FranzenDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Ruppin Brandenburg (ukrb), Brandenburg Medical School, Neuruppin, Germany.

Annekatrin CoordesDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Ruppin Brandenburg (ukrb), Brandenburg Medical School, Neuruppin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Evaluate whether adding pan-mucosal irradiation (50 Gy) reduces recurrence or improves survival in head and neck carcinoma of unknown primary. Methods and Materials: Retrospective 2-center analysis (center 1, 2009-2018, and center 2, 2005-2023). All patients underwent neck dissection with adjuvant irradiation to lymphatic drainage or definitive radiochemotherapy; center 2 additionally received 50 Gy pan-mucosal irradiation to the upper aerodigestive tract. Definitive radiation therapy/chemoradiation therapy was used for advanced nodal disease. Results: Of 164 screened, 134 were included (center 1, n = 88, and center 2, n = 46). Median follow-up was 72 months (95% CI, 48-96). Sixty-five patients (42%) died (37 vs 28). Overall survival did not differ between centers (log-rank Conclusion: In thoroughly staged head and neck carcinoma of unknown primary, adding pan-mucosal irradiation to standard nodal irradiation was not associated with improved survival or lower mucosal recurrence rates compared with nodal-only fields. The late occurrence of mucosal events and their association with persistent smoking suggest second primary tumors rather than missed index lesions. Given potential toxicity and quality-of-life trade-offs, routine pan-mucosal irradiation may not be warranted, and treatment should be individualized.

Identifiers

PMID42662753

DOI10.1016/j.adro.2026.102130

PMCPMC13520607

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