title: Salvage endoscopic nasopharyngectomy is superior to intensity-modulated radiation therapy for local recurrence of selected T1-T3 nasopharyngeal carcinoma – A case-matched comparison.
abstract: BACKGROUND
  Salvage ENPG and IMRT are more effective treatments for rNPC than traditional 2-dimensional radiotherapy. However, compared with IMRT, the benefits of ENPG have not yet been clearly described.
  
  
  METHODS
  We defined a resectable area in which the disease could be radically removed using ENPG and our imaging specialists selected eligible patients with tumors confined to this resectable area from a database of rNPC patients. Using propensity scores to adjust for some potential prognostic factors, a well-balanced cohort of 144 limited rNPC patients was created by matching each patient who underwent ENPG (study group) with one who underwent IMRT (control group). Morbidity, long-term oncological results, treatment-related complications, medical costs, and quality of life were compared.
  
  
  RESULTS
  Compared with IMRT, ENPG was associated with a relatively good overall survival (5-year OS, 77.1% vs 55.5%, P=.003), QOL conservation (mean global health status score, 57.6 vs 29.8, P<.001), and significant decreases in post-treatment complications (12.5% vs 65.3%, P<.001), medical costs (23 645.90 vs 118 122.53 Yuan, P<.001)≈(€2371.71 vs 11,847.80, P<.001).
  
  
  CONCLUSIONS
  Salvage ENPG may be more effective for maximizing survival and QOL benefits and minimizing treatment-related complications and medical costs for limited rNPC patients, as compared with IMRT.
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
authors.forename: Rui
authors.initials: R
authors.lastname: You
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
authors.forename: Xiong
authors.initials: X
authors.lastname: Zou
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
authors.forename: Yi-Jun
authors.initials: YJ
authors.lastname: Hua
authors.affiliation: Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
authors.forename: Fei
authors.initials: F
authors.lastname: Han
authors.affiliation: Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
authors.forename: Chong
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Hong
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, PR China; Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China. Electronic address: chmingy@mail.sysu.edu.cn.
authors.forename: Ming-Yuan
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D002277:Carcinoma; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D013517:Otorhinolaryngologic Surgical Procedures; D011788:Quality of Life; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016879:Salvage Therapy; D016896:Treatment Outcome
keywords: Nasopharyngeal carcinoma; Quality of life; Radiotherapy; Recurrent; Surgery