Re-irradiation for recurrent NPC—is the treatment merited at all?

Edwin Wong, Jessica Hung, Wai-Tong Ng


With advances in radiotherapy (RT) technique and chemotherapy strategies, the survival of patients with nasopharyngeal carcinoma (NPC) has improved substantially in the past few decades, with most intensity-modulated radiation therapy (IMRT) series achieving up to 90% loco-regional control (1). The most common site of recurrence remains to be distant. Local recurrence of NPC, albeit uncommon, is extremely debilitating and difficult to manage. Salvage surgery and re-RT are the only curative treatment options available. Randomized study to compare surgery and re-RT is deemed difficult due to the rarity of the condition and the heterogeneity of this heavily pre-treated population. Treatment choice is, therefore, mainly based on each physician’s discretion, availability of expertise and patient’s choice.