Abstract
Despite advances in technology and improved treatment outcome of nasopharyngeal carcinoma (NPC), local recurrence still represents a major mode of failure particularly in patients with locally advanced disease. It can occur years after the primary treatment and is often associated with devastating local symptoms. Salvage nasopharyngectomy is usually reserved for early relapse disease, while majority of the patients have to rely on re-irradiation as the only chance of cure. Due to the close proximity to adjacent critical structures and previous exposure to high-dose irradiation, the therapeutic window is extremely narrow. The increasing use of chemo-irradiation as the primary treatment may also mean local recurrence occurring in modern era is a clone of tumor cells that is more therapy resistant and difficult to eradicate. Nonetheless, there is a stark paucity of prospective studies to guide our current management for this challenging condition. Better understanding of the radiobiological factors, improvement in radiotherapy techniques, and integration with systemic treatment might enhance the disease control and minimize treatment toxicities. Personalized treatment approach and novel systemic treatment will be the future direction.
The original version of this chapter was revised. An erratum to this chapter can be found at 10.1007/978-3-319-41825-4_78.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ang KK, Price RE, Stephens LC, Jiang GL, Feng Y, Schultheiss TE et al (1993) The tolerance of primate spinal cord to re-irradiation. Int J Radiat Oncol Biol Phys 25:459–464
Bakst RL, Lee N, Pfister DG, Zelefsky MJ, Hunt MA, Kraus DH et al (2011) Hypofractionated dose-painting intensity modulated radiation therapy with chemotherapy for nasopharyngeal carcinoma: a prospective trial. Int J Radiat Oncol Biol Phys 80:148–153
Barnett GC, Coles CE, Elliott RM, Baynes C, Luccarini C, Conroy D et al (2012) Independent validation of genes and polymorphisms reported to be associated with radiation toxicity: a prospective analysis study. Lancet Oncol 13:65–77
Benhaim C, Lapeyre M, Thariat J (2014) Stereotactic irradiation in head and neck cancers. Cancer Radiother 18:280–296
Cao CN, Luo JW, Gao L, Yi JL, Huang XD, Wang K et al (2013) Clinical outcomes and patterns of failure after intensity-modulated radiotherapy for T4 nasopharyngeal carcinoma. Oral Oncol 49:175–181
Chai SJ, Pua KC, Saleh A, Yap YY, Lim PV, Subramaniam SK et al (2012) Clinical significance of plasma Epstein-Barr Virus DNA loads in a large cohort of Malaysian patients with nasopharyngeal carcinoma. J Clin Virol 55:34–39
Chan JY (2014) Surgical management of recurrent nasopharyngeal carcinoma. Oral Oncol 50:913–917
Chan SH, Ng WT, Kam KL, Lee MC, Choi CW, Yau TK et al (2009) Sensorineural hearing loss after treatment of nasopharyngeal carcinoma: a longitudinal analysis. Int J Radiat Oncol Biol Phys 73:1335–1342
Chan YW, Chow VL, Wei WI (2012) Quality of life of patients after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Cancer 118:3710–3718
Chen HJ, Leung SW, Su CY (2001) Linear accelerator based radiosurgery as a salvage treatment for skull base and intracranial invasion of recurrent nasopharyngeal carcinomas. Am J Clin Oncol 24:255–258
Chen J, Dassarath M, Yin Z, Liu H, Yang K, Wu G (2011) Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management. Radiat Oncol (London, England) 6:128
Chen HY, Ma XM, Ye M, Hou YL, Xie HY, Bai YR (2013) Effectiveness and toxicities of intensity-modulated radiotherapy for patients with locally recurrent nasopharyngeal carcinoma. PLoS One 8, e73918
Chua DT, Sham JS, Hung KN, Kwong DL, Kwong PW, Leung LH (1999) Stereotactic radiosurgery as a salvage treatment for locally persistent and recurrent nasopharyngeal carcinoma. Head Neck 21:620–626
Chua DT, Sham JS, Kwong PW, Hung KN, Leung LH (2003) Linear accelerator-based stereotactic radiosurgery for limited, locally persistent, and recurrent nasopharyngeal carcinoma: efficacy and complications. Int J Radiat Oncol Biol Phys 56:177–183
Chua DT, Sham JS, Leung LH, Au GK (2005a) Re-irradiation of nasopharyngeal carcinoma with intensity-modulated radiotherapy. Radiother Oncol 77:290–294
Chua DT, Sham JS, Au GK (2005b) Induction chemotherapy with cisplatin and gemcitabine followed by reirradiation for locally recurrent nasopharyngeal carcinoma. Am J Clin Oncol 28:464–471
Chua DT, Wu SX, Lee V, Tsang J (2009) Comparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis. Head Neck Oncol 1:13
Dizman A, Coskun-Breuneval M, Altinisik-Inan G, Olcay GK, Cetindag MF, Guney Y (2014) Reirradiation with robotic stereotactic body radiotherapy for recurrent nasopharyngeal carcinoma. Asian Pacific J Cancer Prevent 15:3561–3566
Han F, Zhao C, Huang SM, Lu LX, Huang Y, Deng XW et al (2012) Long-term outcomes and prognostic factors of re-irradiation for locally recurrent nasopharyngeal carcinoma using intensity-modulated radiotherapy. Clin Oncol (R Coll Radiol) 24:569–576
Hao SP, Tsang NM, Chang KP (2004) Monitoring tumor recurrence with nasopharyngeal swab and latent membrane protein-1 and epstein-barr nuclear antigen-1 gene detection in treated patients with nasopharyngeal carcinoma. Laryngoscope 114:2027–2030
Hong RL, Lin CY, Ting LL, Ko JY, Hsu MM (2004) Comparison of clinical and molecular surveillance in patients with advanced nasopharyngeal carcinoma after primary therapy: the potential role of quantitative analysis of circulating Epstein-Barr virus DNA. Cancer 100:1429–1437
Hong J, Yao Y, Zhang Y, Tang T, Zhang H, Bao D et al (2013) Value of magnetic resonance diffusion-weighted imaging for the prediction of radiosensitivity in nasopharyngeal carcinoma. Otolaryngol Head Neck Surg 149:707–713
Hou X, Zhao C, Guo Y, Han F, Lu LX, Wu SX et al (2011) Different clinical significance of pre- and post-treatment plasma Epstein-Barr virus DNA load in nasopharyngeal carcinoma treated with radiotherapy. Clin Oncol (R Coll Radiol) 23:128–133
Hsu CL, Chan SC, Chang KP, Lin TL, Lin CY, Hsieh CH et al (2013) Clinical scenario of EBV DNA follow-up in patients of treated localized nasopharyngeal carcinoma. Oral Oncol 49:620–625
Hsu C, Lee SH, Ejadi S, Even C, Cohen R, Le Tourneau C, Mehnert J (2015) Antitumor activity and safety of pembrolizumab in patients with PD-L1-positive nasopharyngeal carcinoma: Interim results from a phase 1b study positive nasopharyngeal carcinoma. Ann Oncol 26(suppl 9):ix94
Hua YJ, Han F, Lu LX, Mai HQ, Guo X, Hong MH et al (2012) Long-term treatment outcome of recurrent nasopharyngeal carcinoma treated with salvage intensity modulated radiotherapy. Eur J Cancer 48:3422–3428
Huang XM, Zheng YQ, Zhang XM, Mai HQ, Zeng L, Liu X et al (2006) Diagnosis and management of skull base osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma. Laryngoscope 116:1626–1631
Hui EP, Ma BB, King AD, Mo F, Chan SL, Kam MK et al (2011) Hemorrhagic complications in a phase II study of sunitinib in patients of nasopharyngeal carcinoma who has previously received high-dose radiation. Ann Oncol 22:1280–1287
Hwang JM, Fu KK, Phillips TL (1998) Results and prognostic factors in the retreatment of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 41:1099–1111
Jiang F, Jin T, Feng XL, Jin QF, Chen XZ (2015) Long-term outcomes and failure patterns of patients with nasopharyngeal carcinoma staged by magnetic resonance imaging in intensity-modulated radiotherapy era: The Zhejiang Cancer Hospital's experience. J Cancer Res Ther 11(Suppl 2):C179–C184
Jones B, Grant W (2014) Retreatment of central nervous system tumours. Clin Oncol (R Coll Radiol) 26:407–418
Karam I, Huang SH, McNiven A, Su J, Xu W, Waldron J et al (2015) Outcomes after reirradiation for recurrent nasopharyngeal carcinoma: North American experience. Head Neck
Kong FF, Ying H, Du CR, Huang S, Zhou JJ, Hu CS (2014) Effectiveness and toxicities of intensity-modulated radiation therapy for patients with T4 nasopharyngeal carcinoma. PLoS One 9, e91362
Koutcher L, Lee N, Zelefsky M, Chan K, Cohen G, Pfister D et al (2010) Reirradiation of locally recurrent nasopharynx cancer with external beam radiotherapy with or without brachytherapy. Int J Radiat Oncol Biol Phys 76:130–137
Kwong DL, Nicholls J, Wei WI, Chua DT, Sham JS, Yuen PW et al (1999) The time course of histologic remission after treatment of patients with nasopharyngeal carcinoma. Cancer 85:1446–1453
Kwong DL, Wei WI, Cheng AC, Choy DT, Lo AT, Wu PM et al (2001) Long term results of radioactive gold grain implantation for the treatment of persistent and recurrent nasopharyngeal carcinoma. Cancer 91:1105–1113
Lai V, Li X, Lee VH, Lam KO, Chan Q, Khong PL (2013) Intravoxel incoherent motion MR imaging: comparison of diffusion and perfusion characteristics between nasopharyngeal carcinoma and post-chemoradiation fibrosis. Eur Radiol 23:2793–2801
Lam JW, Chan JY, Ho WK, Tsang RK (2015) Use of transoral nasopharyngeal brush biopsy for Epstein-Barr virus DNA detection of local recurrence of nasopharyngeal carcinoma after radiotherapy. Head Neck. doi: 10.1002/hed.24216. [Epub ahead of print]
Lartigau EF, Tresch E, Thariat J, Graff P, Coche-Dequeant B, Benezery K et al (2013) Multi institutional phase II study of concomitant stereotactic reirradiation and cetuximab for recurrent head and neck cancer. Radiother Oncol 109:281–285
Law SC, Lam WK, Ng MF, Au SK, Mak WT, Lau WH (2002) Reirradiation of nasopharyngeal carcinoma with intracavitary mold brachytherapy: an effective means of local salvage. Int J Radiat Oncol Biol Phys 54:1095–1113
Lee AW, Foo W, Law SC, Poon YF, Sze WM, O SK et al (1997) Reirradiation for recurrent nasopharyngeal carcinoma: factors affecting the therapeutic ratio and ways for improvement. Int J Radiat Oncol Biol Phys 38:43–52
Lee AW, Foo W, Chappell R, Fowler JF, Sze WM, Poon YF et al (1998) Effect of time, dose, and fractionation on temporal lobe necrosis following radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 40:35–42
Lee AW, Foo W, Law SC, Poon YF, Sze WM, O SK et al (1999) Recurrent nasopharyngeal carcinoma: the puzzles of long latency. Int J Radiat Oncol Biol Phys 44:149–156
Lee AW, Foo W, Law SC, Peters LJ, Poon YF, Chappell R et al (2000) Total biological effect on late reactive tissues following reirradiation for recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 46:865–872
Lee AW, Kwong DL, Leung SF, Tung SY, Sze WM, Sham JS et al (2002) Factors affecting risk of symptomatic temporal lobe necrosis: significance of fractional dose and treatment time. Int J Radiat Oncol Biol Phys 53:75–85
Lee AW, Fee WE Jr, Ng WT, Chan LK (2012) Nasopharyngeal carcinoma: salvage of local recurrence. Oral Oncol 48:768–774
Lee AW, Ng WT, Chan LL, Hung WM, Chan CC, Sze HC et al (2014) Evolution of treatment for nasopharyngeal cancer--success and setback in the intensity-modulated radiotherapy era. Radiother Oncol 110:377–384
Leung TW, Tung SY, Sze WK, Sze WM, Wong VY, O SK (2000a) Salvage brachytherapy for patients with locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 47:405–412
Leung TW, Tung SY, Sze WK, Sze WM, Wong VY, Wong CS et al (2000b) Salvage radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 48:1331–1338
Leung SF, Lo YM, Chan AT, To KF, To E, Chan LY et al (2003) Disparity of sensitivities in detection of radiation-naive and postirradiation recurrent nasopharyngeal carcinoma of the undifferentiated type by quantitative analysis of circulating Epstein-Barr virus DNA1,2. Clin Cancer Res 9:3431–3434
Leung SF, Zee B, Ma BB, Hui EP, Mo F, Lai M et al (2006) Plasma Epstein-Barr viral deoxyribonucleic acid quantitation complements tumor-node-metastasis staging prognostication in nasopharyngeal carcinoma. J Clin Oncol 24:5414–5418
Leung TW, Wong VY, Tung SY (2009) Stereotactic radiotherapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 75:734–741
Li JC, Hu CS, Jiang GL, Mayr NA, Wang JZ, He XY et al (2006) Dose escalation of three-dimensional conformal radiotherapy for locally recurrent nasopharyngeal carcinoma: a prospective randomised study. Clin Oncol (R Coll Radiol) 18:293–299
Li JX, Lu TX, Huang Y, Han F (2012) Clinical characteristics of recurrent nasopharyngeal carcinoma in high-incidence area. Sci World J 719754
Liang SB, Sun Y, Liu LZ, Chen Y, Chen L, Mao YP et al (2009) Extension of local disease in nasopharyngeal carcinoma detected by magnetic resonance imaging: improvement of clinical target volume delineation. Int J Radiat Oncol Biol Phys 75:742–750
Lin R, Slater JD, Yonemoto LT, Grove RI, Teichman SL, Watt DK et al (1999) Nasopharyngeal carcinoma: repeat treatment with conformal proton therapy--dose-volume histogram analysis. Radiology 213:489–494
Lin JC, Wang WY, Chen KY, Wei YH, Liang WM, Jan JS et al (2004) Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma. New Engl J Med 350:2461–2470
Liu S, Lu T, Zhao C, Shen J, Tian Y, Guan Y et al (2014) Temporal lobe injury after re-irradiation of locally recurrent nasopharyngeal carcinoma using intensity modulated radiotherapy: clinical characteristics and prognostic factors. J Neuro Oncol 119:421–428
Luo W, Ye L, Yu Z, He Z, Li F, Liu M (2010) Effectiveness of three-dimensional conformal radiotherapy for treating early primary nasopharyngeal carcinoma. Am J Clin Oncol 33:604–608
Mason KA, Withers HR, Chiang CS (1993) Late effects of radiation on the lumbar spinal cord of guinea pigs: re-treatment tolerance. Int J Radiat Oncol Biol Phys 26:643–648
Mayer R, Sminia P (2008) Reirradiation tolerance of the human brain. Int J Radiat Oncol Biol Phys 70:1350–1360
McDonald MW, Moore MG, Johnstone PA (2012) Risk of carotid blowout after reirradiation of the head and neck: a systematic review. Int J Radiat Oncol Biol Phys 82:1083–1089
Ngan RK, Ng WT, Kwong D, Tung S, Yau CC, Leung SF, Chan WY, Lung M, Lee A (2015) Preliminary results of HKNPC-1001 trial to evaluate the role of induction TPF followed by weekly docetaxel and cetuximab in combination with intensity modulated radiotherapy for locally advanced nasopharyngeal carcinoma. Ann Oncol 26(Suppl 9):ix93–ix102
Nieder C, Grosu AL, Andratschke NH, Molls M (2005) Proposal of human spinal cord reirradiation dose based on collection of data from 40 patients. Int J Radiat Oncol Biol Phys 61:851–855
Nieder C, Grosu AL, Andratschke NH, Molls M (2006) Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. Int J Radiat Oncol Biol Phys 66:1446–1449
Ozyigit G, Cengiz M, Yazici G, Yildiz F, Gurkaynak M, Zorlu F et al (2011) A retrospective comparison of robotic stereotactic body radiotherapy and three-dimensional conformal radiotherapy for the reirradiation of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 81:e263–e268
Poon D, Yap SP, Wong ZW, Cheung YB, Leong SS, Wee J et al (2004) Concurrent chemoradiotherapy in locoregionally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 59:1312–1318
Pryzant RM, Wendt CD, Delclos L, Peters LJ (1992) Re-treatment of nasopharyngeal carcinoma in 53 patients. Int J Radiat Oncol Biol Phys 22:941–947
Qiu S, Lin S, Tham IW, Pan J, Lu J, Lu JJ (2012) Intensity-modulated radiation therapy in the salvage of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 83:676–683
Qiu S, Lu J, Zheng W, Xu L, Lin S, Huang C et al (2014) Advantages of intensity modulated radiotherapy in recurrent T1-2 nasopharyngeal carcinoma: a retrospective study. BMC Cancer 14:797
Rattay T, Talbot CJ (2014) Finding the genetic determinants of adverse reactions to radiotherapy. Clin Oncol (R Coll Radiol) 26:301–308
Ruifrok AC, Kleiboer BJ, van der Kogel AJ (1992) Reirradiation tolerance of the immature rat spinal cord. Radiother Oncol 23:249–256
Seiwert TY, Haraf DJ, Cohen EE, Stenson K, Witt ME, Dekker A et al (2008) Phase I study of bevacizumab added to fluorouracil- and hydroxyurea-based concomitant chemoradiotherapy for poor-prognosis head and neck cancer. J Clin Oncol 26:1732–1741
Seo Y, Yoo H, Yoo S, Cho C, Yang K, Kim MS et al (2009) Robotic system-based fractionated stereotactic radiotherapy in locally recurrent nasopharyngeal carcinoma. Radiother Oncol 93:570–574
Setton J, Han J, Kannarunimit D, Wuu YR, Rosenberg SA, DeSelm C et al (2015) Long-term patterns of relapse and survival following definitive intensity-modulated radiotherapy for non-endemic nasopharyngeal carcinoma. Oral Oncol 53:67–73
Shen X, Li Y, Zhang Y, Kong J, Li Y (2015) An analysis of brachytherapy with computed tomography-guided permanent implantation of Iodine-125 seeds for recurrent nonkeratin nasopharyngeal carcinoma. Onco Targets Ther 8:991–997
Sulman EP, Schwartz DL, Le TT, Ang KK, Morrison WH, Rosenthal DI et al (2009) IMRT reirradiation of head and neck cancer-disease control and morbidity outcomes. Int J Radiat Oncol Biol Phys 73:399–409
Sun X, Su S, Chen C, Han F, Zhao C, Xiao W et al (2014) Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol 110:398–403
Teo PM, Kwan WH, Chan AT, Lee WY, King WW, Mok CO (1998) How successful is high-dose (> or = 60 Gy) reirradiation using mainly external beams in salvaging local failures of nasopharyngeal carcinoma? Int J Radiat Oncol Biol Phys 40:897–913
Tian YM, Zhao C, Guo Y, Huang Y, Huang SM, Deng XW et al (2014) Effect of total dose and fraction size on survival of patients with locally recurrent nasopharyngeal carcinoma treated with intensity-modulated radiotherapy: a phase 2, single-center, randomized controlled trial. Cancer 120:3502–3509
Tian YM, Xiao WW, Bai L, Liu XW, Zhao C, Lu TX et al (2015) Impact of primary tumor volume and location on the prognosis of patients with locally recurrent nasopharyngeal carcinoma. Chin J Cancer 34:247–253
Tsang RK, Ho WK, Wei WI, Chan JY (2013) Transoral robotic assisted nasopharyngectomy via a lateral palatal flap approach. Laryngoscope 123:2180–2183
van der Kogel AJ (1993) Retreatment tolerance of the spinal cord. Int J Radiat Oncol Biol Phys 26:715–717
Vargo JA, Ferris RL, Ohr J, Clump DA, Davis KS, Duvvuri U et al (2015) A prospective phase 2 trial of reirradiation with stereotactic body radiation therapy plus cetuximab in patients with previously irradiated recurrent squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 91:480–488
Wang CC (1987) Re-irradiation of recurrent nasopharyngeal carcinoma--treatment techniques and results. Int J Radiat Oncol Biol Phys 13:953–956
Wang WH, Lin YC, Chen WC, Chen MF, Chen CC, Lee KF (2012) Detection of mucosal recurrent nasopharyngeal carcinomas after radiotherapy with narrow-band imaging endoscopy. Int J Radiat Oncol Biol Phys 83:1213–1219
Wang R, Wu F, Lu H, Wei B, Feng G, Li G et al (2013) Definitive intensity-modulated radiation therapy for nasopharyngeal carcinoma: long-term outcome of a multicenter prospective study. J Cancer Res Clin Oncol 139:139–145
Wei J, Pei S, Zhu X (2015) Comparison of (18)F-FDG PET/CT, MRI and SPECT in the diagnosis of local residual/recurrent nasopharyngeal carcinoma: A meta-analysis. Oral Oncol
Widesott L, Pierelli A, Fiorino C, Dell'oca I, Broggi S, Cattaneo GM et al (2008) Intensity-modulated proton therapy versus helical tomotherapy in nasopharynx cancer: planning comparison and NTCP evaluation. Int J Radiat Oncol Biol Phys 72:589–596
Wong CS, Poon JK, Hill RP (1993) Re-irradiation tolerance in the rat spinal cord: influence of level of initial damage. Radiother Oncol 26:132–138
Xiao W, Liu S, Tian Y, Guan Y, Huang S, Lin C et al (2015) Prognostic significance of tumor volume in locally recurrent nasopharyngeal carcinoma treated with salvage intensity-modulated radiotherapy. PLoS One 10, e0125351
Xu T, Ou X, Shen C, Hu C (2016) Cetuximab in combination with chemoradiotherapy in the treatment of recurrent and/or metastatic nasopharyngeal carcinoma. Anticancer Drugs 27:66–70
Yau TK, Sze WM, Lee WM, Yeung MW, Leung KC, Hung WM et al (2004) Effectiveness of brachytherapy and fractionated stereotactic radiotherapy boost for persistent nasopharyngeal carcinoma. Head Neck 26:1024–1030
Yen RF, Hung RL, Pan MH, Wang YH, Huang KM, Lui LT et al (2003) 18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging. Cancer 98:283–287
Yu KH, Leung SF, Tung SY, Zee B, Chua DT, Sze WM et al (2005) Survival outcome of patients with nasopharyngeal carcinoma with first local failure: a study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Head Neck 27:397–405
Zheng XK, Chen LH, Chen YQ, Deng XG (2004) Three-dimensional conformal radiotherapy versus intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 60:165–170
Zheng XK, Ma J, Chen LH, Xia YF, Shi YS (2005) Dosimetric and clinical results of three-dimensional conformal radiotherapy for locally recurrent nasopharyngeal carcinoma. Radiother Oncol 75:197–203
Zhou X, Ou X, Xu T, Wang X, Shen C, Ding J et al (2014) Effect of dosimetric factors on occurrence and volume of temporal lobe necrosis following intensity modulated radiation therapy for nasopharyngeal carcinoma: a case–control study. Int J Radiat Oncol Biol Phys 90:261–269
Acknowledgment
The authors wish to thank Dr. Michael C. H. Lee (Department of Medical Physics, Pamela Youde Nethersole Eastern Hospital) for his contributions on the section of “radiobiological factors.”
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Ng, W.T., Chan, O.S.H., Sze, H.C.K., Lee, A.W.M. (2016). Nasopharyngeal Carcinoma. In: Nieder, C., Langendijk, J. (eds) Re-Irradiation: New Frontiers. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2016_48
Download citation
DOI: https://doi.org/10.1007/174_2016_48
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-41823-0
Online ISBN: 978-3-319-41825-4
eBook Packages: MedicineMedicine (R0)