title: Retrospective analysis of patients with nasopharyngeal carcinoma treated during 1976-1985: survival after local recurrence.
abstract: OBJECTIVE
  To study the value of re-irradiation, the overall survival and pattern of failures for patients with nasopharyngeal recurrence.
  
  
  METHODS
  All the 891 patients with local recurrence following radiotherapy for nasopharyngeal carcinoma during 1976-1981 were retrospectively analyzed. Only 70% of them had local failure alone at the time of detection, and the T-stage distribution (by Ho's system) was 31% rT1, 16% rT2, 51% rT3, and 1% rT?. Seven hundred and six (79%) patients had been re-irradiated with various techniques and doses. Among those who failed, 50 had further irradiation.
  
  
  RESULTS
  The overall 5- and 10-year actuarial cancer-specific survival rates were 14% and 9%, respectively. Patients with rT3 disease had the worst prognosis. Successful local salvage was achieved in 32% of those re-irradiated (26% of the whole series). The highest control rate was achieved by those treated with external radiotherapy to 60 Gy (equivalent) or above. Only 8/50 patients responded to the third course of radiotherapy. The cumulative incidence of late post-re-irradiation sequelae was 24%, and the treatment mortality rate 1.8%. Besides local failure, 54% had regional relapse and/or distant metastasis. Thus, only 16% of recurrent patients were totally disease-free at final assessment.
  
  
  CONCLUSIONS
  The overall prognosis for patients with nasopharyngeal recurrence was grave. High dose re-irradiation could achieve successful local salvage in a substantial number of patients with early recurrence, but late complications did occur. Furthermore, high incidence of failure at other sites was observed.
authors.affiliation: Institute of Radiology and Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong.
authors.forename: A W
authors.initials: AW
authors.lastname: Lee
authors.forename: S C
authors.initials: SC
authors.lastname: Law
authors.forename: W
authors.initials: W
authors.lastname: Foo
authors.forename: Y F
authors.initials: YF
authors.lastname: Poon
authors.forename: F K
authors.initials: FK
authors.lastname: Cheung
authors.forename: D K
authors.initials: DK
authors.lastname: Chan
authors.forename: S Y
authors.initials: SY
authors.lastname: Tung
authors.forename: M
authors.initials: M
authors.lastname: Thaw
authors.forename: J H
authors.initials: JH
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000453:epidemiology / Q000532:radiotherapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate