title: Long-term survival and late complications in intensity-modulated radiotherapy of locally recurrent T1 to T2 nasopharyngeal carcinoma.
abstract: BACKGROUND
  We investigated the feasibility of reirradiation with intensity-modulated radiotherapy (IMRT) for recurrent T1 to T2 nasopharyngeal carcinoma (NPC) by assessing long-term survival and late complication rates.
  
  
  METHODS
  Sixty patients who had been previously irradiated were diagnosed with locally recurrent T1 to T2 NPC and underwent reirradiation with IMRT. Severe radiation toxicities were assessed.
  
  
  RESULTS
  The median follow-up time was 40.0 months. The 5-year local failure-free survival (LFFS), distant failure-free survival (DFFS), and overall survival (OS) rates were 85.7%, 96.1%, and 67.2%, respectively. Independent prognostic factors included primary gross tumor volume >20 cm and the presence of significant complications. The most common severe complications were headache (31.6%), mucosal necrosis (30.0%), cranial neuropathy (25.0%), and temporal lobe necrosis (21.6%). Thirty-nine patients (65.0%) developed at least one severe complication and 18 patients died as a result.
  
  
  CONCLUSIONS
  Excellent disease control can be achieved by reirradiation with IMRT for recurrent T1 to T2 NPC. However, the main challenge remains severe late complications.
authors.affiliation: Department of Radiation Oncology, Hui Zhou Municipal Centre Hospital, Guangdong Province, People's Republic of China.
authors.forename: Yun-Ming
authors.initials: YM
authors.lastname: Tian
authors.affiliation: Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou Province, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Guan
authors.affiliation: Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou Province, People's Republic of China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Xiao
authors.affiliation: Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou Province, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zeng
authors.affiliation: Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou Province, People's Republic of China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Liu
authors.affiliation: Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou Province, People's Republic of China.
authors.forename: Tai-Xiang
authors.initials: TX
authors.lastname: Lu
authors.affiliation: Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou Province, People's Republic of China.
authors.forename: Chong
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Sun Yat-Sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou Province, People's Republic of China.
authors.forename: Fei
authors.initials: F
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D003389:Cranial Nerve Diseases / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D009336:Necrosis / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D013702:Temporal Lobe / Q000473:pathology
keywords: early-stage; intensity-modulated radiotherapy (IMRT); late complications; local recurrence; nasopharyngeal carcinoma (NPC)