Clinical Research Papers:

The challenge in treating locally recurrent T3-4 nasopharyngeal carcinoma: the survival benefit and severe late toxicities of re-irradiation with intensity-modulated radiotherapy

Yun-Ming Tian _, Wei-Zeng Huang, Xia Yuan, Li Bai, Chong Zhao and Fei Han

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Oncotarget. 2017; 8:43450-43457. https://doi.org/10.18632/oncotarget.15896

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Yun-Ming Tian1,2,*, Wei-Zeng Huang3,*, Xia Yuan3,*, Li Bai1, Chong Zhao2 and Fei Han2

1 Department of Radiation Oncology, Hui Zhou Municipal Centre Hospital, Huizhou, Guangdong, P.R. China

2 Department of Radiation Oncology, Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P.R. China

3 Department of Medical Oncology, Hui Zhou Municipal Centre Hospital, Huizhou, Guangdong, P.R. China

* These authors have contributed equally to this work

Correspondence to:

Fei Han, email:

Keywords: nasopharyngeal carcinoma; local recurrence; intensity-modulated radiotherapy; late complications

Received: September 06, 2016 Accepted: February 06, 2017 Published: March 04, 2017


Background: Effective treatments for patients with advanced locally recurrent nasopharyngeal carcinoma (NPC) are limited. This investigation was to determine the potential benefits from re-irradiation by intensity-modulated radiotherapy (IMRT) on survival and the effects of severe late toxicities.

Methods: A retrospective study was conducted in 245 patients diagnosed with locally recurrent T3–T4 NPC who had undergone re-irradiation with IMRT. Follow-up data was colleted and factors associated with survival and severe late toxicities were analyzed.

Results: The 5-year local-regional failure-free survival, distant failure-free survival and overall survival rates were 60.9%, 78.3% and 27.5%, respectively. The presence of severe late complications, recurrent T4 disease and gross tumor volume >30 cm3 were associated with poor survival. The incidences of mucosal necrosis, temporal lobe necrosis, cranial neuropathy and trismus were 22.0%, 14.6%, 27.0% and 14.6% respectively. Conclusions: Re-irradiation with IMRT is an effective choice in patients with locally recurrent T3–T4 NPC. However, the survival benefits can be partly offset by severe late complications and optimum treatments in these patients remain a challenge.

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