Clinical characteristics and long-term outcomes of individualized re-treatment in locoregionally recurrent nasopharyngeal carcinoma

OBJECTIVES To evaluate clinical characteristics and long-term outcomes of individualized re-treatment in patients with different locoregionally recurrent patterns of nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS From January 2005 to December 2018, sixty-five locoregionally recurrent NPC patients were included in the study. The location of recurrence determined different treatments with radiotherapy (RT) and/or surgery. RESULTS The median age at the time of re-treatment was 51 years old. Twenty-nine (44.6%) patients had tumors classified as T3-4 and forty-four (67.7%) patients had tumors classified as N2-3 in the initial treatment. All patients were previously treated with intensity-modulated radiotherapy (IMRT) to a median dose of 66Gy (range, 66–70.4Gy). The median time between initial treatment and recurrence was 25 months (range: 10–105 months). Tumor relapse was classified as rT3-4 in 19 patients and rN2-3 in 8 patients. The median interval between the date of locoregional relapse to the date of death or last follow-up was 28 months (range: 0 to 112 months). The overall survival (OS) at 1-year, 3-years, and 5-years was 94.4%, 67.3%, and 47.2%, respectively. Age at the time of recurrence (> 45 years) altered the OS significantly (P = 0.007). CONCLUSIONS Locoregionally recurrent NPC should be individualized re-treatment. Therapy modality according to the recurrent site achieved relatively satisfactory long-term survival outcomes. Age at the time of recurrence (> 45 years) served as negatively prognostic factor of OS.