title: Outcomes after reirradiation for recurrent nasopharyngeal carcinoma: North American experience.
abstract: The purpose of this article was to report outcomes of reirradiation for locoregionally recurrent nasopharyngeal carcinoma (NPC).
  
  
  
  A retrospective review was conducted of all patients with locoregionally recurrent NPC who received reirradiation between 2001 and 2012. Overall survival (OS), local control, regional control, distant control, and Radiation Therapy Oncology Group (RTOG) grades 3 to 4 late toxicity were examined.
  
  
  
  A total of 42 recurrent cases treated with intensity-modulated radiotherapy (IMRT; 27 patients) or non-IMRT (stereotactic radiotherapy [RT], 12 patients; 3D conformal RT, 3 patients) were identified. Median time from initial RT to recurrence was 4.6 years. Hyperfractionation with 1.1 to 1.4 Gy/fraction twice daily to a total of 40 to 60 Gy was used in 27 IMRT and 5 non-IMRT patients. The remaining 10 patients received conventional fractionation 1.8 to 2.0 Gy/fraction to 50 to 60 Gy. Median follow-up was 3.0 years. The 3-year OS, local control, regional control, distant control, and late toxicity rates were 49%, 46%, 71%, 79%, and 37%, respectively.
  
  
  
  Reirradiation for recurrent NPC, delivered mostly with hyperfractionated IMRT, can result in durable disease control with acceptable late toxicity. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1102-E1109, 2016.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Irene
authors.initials: I
authors.lastname: Karam
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Shao Hui
authors.initials: SH
authors.lastname: Huang
authors.affiliation: Department of Medical Physics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: McNiven
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jie
authors.initials: J
authors.lastname: Su
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Waldron
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bayley
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Cho
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Jolie
authors.initials: J
authors.lastname: Ringash
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hope
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Biu
authors.initials: B
authors.lastname: Chan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Canada.
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Giuliani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D000069475:Re-Irradiation; D012189:Retrospective Studies
keywords: intensity-modulated radiotherapy (IMRT) toxicity; locoregional recurrence; nasopharyngeal cancer; radiotherapy; reirradiation