title: Recurrence of nasopharyngeal carcinoma in the parotid region after definitive intensity-modulated radiotherapy.
abstract: OBJECTIVE
  To discuss the clinical characteristics and management of periparotid recurrence of nasopharyngeal carcinoma after definitive intensity-modulated radiotherapy.
  
  
  METHODS
  The authors retrospectively reviewed the charts of 716 patients with nasopharyngeal carcinoma who underwent intensity-modulated radiotherapy at their center from January 2005 through December 2010. Disease recurred in a spared parotid gland in 10 patients (1.4%). After periparotid recurrence, 4 patients received surgery alone, 1 patient received radiotherapy alone, 2 patients received chemotherapy alone, 2 patients received surgery plus chemotherapy, and 1 patient received surgery plus radiotherapy.
  
  
  RESULTS
  After a median follow-up of 42.6 months (19.8 to 86.0 months), 4 patients died of tumor progression. The median survival time after periparotid recurrence was 25.1 months (5.0 to 74.5 months).
  
  
  CONCLUSIONS
  Periparotid recurrence is an uncommon pattern of failure after definitive intensity-modulated radiotherapy for nasopharyngeal carcinoma, and there were some long-term survivors in this patient population after salvage treatment.
authors.affiliation: Professor, Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Cai-Neng
authors.initials: CN
authors.lastname: Cao
authors.forename: Jing-Wei
authors.initials: JW
authors.lastname: Luo
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Guo-Zhen
authors.initials: GZ
authors.lastname: Xu
authors.forename: Su-Yan
authors.initials: SY
authors.lastname: Li
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Xiao
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000532:radiotherapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D037981:Neck Dissection; D009367:Neoplasm Staging; D010166:Palliative Care; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000556:secondary* / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate