Radiation therapy of recurrent nasopharyngeal carcinoma. Report on 219 patients.

Recurrent nasopharyngeal carcinoma (NPC), if left untreated, has a 5-year survival of less than one per cent. In contrast, the overall 5-year survival in a treated series of patients was 18 per cent. Excluding those with distant metastases at the beginning of the retreatment, the 5-year survival was 23 per cent. If the recurrence was limited to the neck, a 5-year survival of 34 per cent was obtained and if it was confined to the nasopharynx the 5-year survival was 25 per cent. High doses (about 60 Gy), using multiple narrow beams, carefully directed, were required. For recurrences in the neck, lymph node dissection supplemented by a lower radiation dose should be considered. Surgery was sometimes the only possible method for cure, when recurrence occurred in the neck nodes. Recurrences in the neck, especially when repeatedly appearing, most often were combined with a local recurrence in the nasopharynx.