Skip to main content
SpringerLink
Log in

Management of Nasopharyngeal Carcinoma

  • Chapter
  • First Online:
Head and Neck Cancer

  • 2521 Accesses

Abstract

Nasopharyngeal carcinoma is a distinctly radiosensitive and chemosensitive tumor. Best quality radiotherapy is demanded to build up the complex concave high-dose zone for this critical location. Intensity-modulated radiotherapy (IMRT) is advocated; image guidance to ensure setup precision and adaptive re-planning if major deviations from intended dose distribution occur during the treatment course are useful improvements if resources allow. Stringent dose constraint to organs at risk should be attempted to minimize late toxicities. Addition of cisplatin-based concurrent-adjuvant chemotherapy is recommended for patients with stages III–IVB and high-risk stage IIB diseases. Contemporary series using IMRT together with extensive use of chemotherapy reported very encouraging long-term results with locoregional control in excess of 85 % at 5 years; the key remaining problems are advanced T4 disease and distant failure. Further improvement of efficacy by more potent systemic therapy and changing chemotherapy sequence to induction-concurrent is being explored.

The plasma level of Epstein–Barr Viral Deoxyribonucleic Acid is a well-established tool for non-keratinizing carcinoma for prognostication and monitoring disease progress. Integrated fluorodeoxyglucose positron emission tomography and computed tomography is useful for excluding distant metastases and posttreatment persistent/recurrent disease. Early detection of failure is critical; and aggressive treatment should be attempted as long survival could be achieved for patients with limited failure. Different salvage methods and reported results are summarized.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase No. 11. Lyon: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr. Accessed 26 Oct 2014.

  2. Buell P. The effect of migration on the risk of nasopharyngeal cancer among Chinese. Cancer Res. 1974;34(5):1189–91.

    CAS  PubMed  Google Scholar 

  3. Ng WT, Choi CW, Lee MC, Chan SH, Yau TK, Lee AW. Familial nasopharyngeal carcinoma in Hong Kong: epidemiology and implication in screening. Fam Cancer. 2009;8(2):103–8.

    Article  PubMed  Google Scholar 

  4. Hildesheim A, Wang CP. Genetic predisposition factors and nasopharyngeal carcinoma risk: a review of epidemiological association studies, 2000–2011: Rosetta Stone for NPC: genetics, viral infection, and other environmental factors. Semin Cancer Biol. 2012;22(2):107–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Raab-Traub N. Epstein-Barr virus in the pathogenesis of NPC. Semin Cancer Biol. 2002;12(6):431–41.

    Article  CAS  PubMed  Google Scholar 

  6. Pathmanathan R, Prasad U, Sadler R, Flynn K, Raab-Traub N. Clonal proliferations of cells infected with Epstein-Barr virus in preinvasive lesions related to nasopharyngeal carcinoma. N Engl J Med. 1995;333(11):693–8.

    Article  CAS  PubMed  Google Scholar 

  7. Lee AW, Foo W, Mang O, Sze WM, Chappell R, Lau WH, et al. Changing epidemiology of nasopharyngeal carcinoma in Hong Kong over a 20-year period (1980–99): an encouraging reduction in both incidence and mortality. Int J Cancer. 2003;103(5):680–5.

    Article  CAS  PubMed  Google Scholar 

  8. Hsu C, Shen YC, Cheng CC, Hong RL, Chang CJ, Cheng AL. Difference in the incidence trend of nasopharyngeal and oropharyngeal carcinomas in Taiwan: implication from age-period-cohort analysis. Cancer Epidemiol Biomarkers Prev. 2006;15(5):856–61.

    Article  PubMed  Google Scholar 

  9. Chan JKC, et al. Nasopharyngeal carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics. Head and neck tumors. Lyon: IARC Press; 2005. p. 85–97.

    Google Scholar 

  10. Nicholls J, et al. Histopathological diagnosis of nasopharyngeal carcinoma: looking beyond the blue book. In: Pierre Busson, editor. Nasopharyngeal carcinoma. Keys for translational medicine and biology. New York: Springer; 2013. p. 10–22.

    Google Scholar 

  11. Wang XS, Yan C, Hu CS, Ying HM, He XY, Zhou ZR, et al. Study of the medial group retropharyngeal node metastasis from nasopharyngeal carcinoma based on 3100 newly diagnosed cases. Oral Oncol. 2014;50(11):1109–13.

    Article  CAS  PubMed  Google Scholar 

  12. Ng WT, Lee AW, Kan WK, Chan J, Pang ES, Yau TK, et al. N-staging by magnetic resonance imaging for patients with nasopharyngeal carcinoma: pattern of nodal involvement by radiological levels. Radiother Oncol. 2007;82(1):70–5.

    Article  PubMed  Google Scholar 

  13. Ng SH, Chang JT, Chan SC, Ko SF, Wang HM, Liao CT, et al. Nodal metastases of nasopharyngeal carcinoma: patterns of disease on MRI and FDG PET. Eur J Nucl Med Mol Imaging. 2004;31(8):1073–80.

    Article  PubMed  Google Scholar 

  14. Li JG, Yuan X, Zhang LL, Tang YQ, Liu L, Chen XD, et al. A randomized clinical trial comparing prophylactic upper versus whole-neck irradiation in the treatment of patients with node-negative nasopharyngeal carcinoma. Cancer. 2013;119(17):3170–6.

    Article  PubMed  Google Scholar 

  15. Lee AW, Ng WT, Chan LK, Chan OS, Hung WM, Chan CC, et al. The strength/weakness of the AJCC/UICC staging system (7th edition) for nasopharyngeal cancer and suggestions for future improvement. Oral Oncol. 2012;48(10):1007–13.

    Article  PubMed  Google Scholar 

  16. Chan OS, Ngan RK. Individualized treatment in stage IVC nasopharyngeal carcinoma. Oral Oncol. 2014;50(9):791–7.

    Article  PubMed  Google Scholar 

  17. Pan CC, Lu J, Yu JR, Chen P, Li W, Huang ZL, et al. Challenges in the modification of the M1 stage of the TNM staging system for nasopharyngeal carcinoma: a study of 1027 cases and review of the literature. Exp Ther Med. 2012;4(2):334–8.

    PubMed  PubMed Central  Google Scholar 

  18. Hui EP, Leung SF, Au JS, Zee B, Tung S, Chua D, et al. Lung metastasis alone in nasopharyngeal carcinoma: a relatively favorable prognostic group. A study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Cancer. 2004;101(2):300–6.

    Article  PubMed  Google Scholar 

  19. Li S, Deng Y, Li X, Chen QP, Liao XC, Qin X. Diagnostic value of Epstein-Barr virus capsid antigen-IgA in nasopharyngeal carcinoma: a meta-analysis. Chin Med J (Engl). 2010;123(9):1201–5.

    Google Scholar 

  20. Zeng Y, Zhong JM, Li LY, Wang PZ, Tang H, Ma YR, et al. Follow-up studies on Epstein-Barr virus IgA/VCA antibody-positive persons in Zangwu County, China. Intervirology. 1983;20(4):190–4.

    Article  CAS  PubMed  Google Scholar 

  21. Zong YS, Sham JS, Ng MH, Ou XT, Guo YQ, Zheng SA, et al. Immunoglobulin A against viral capsid antigen of Epstein-Barr virus and indirect mirror examination of the nasopharynx in the detection of asymptomatic nasopharyngeal carcinoma. Cancer. 1992;69(1):3–7.

    Article  CAS  PubMed  Google Scholar 

  22. Ng WT, Yau TK, Yung RW, Sze WM, Tsang AH, Law AL, et al. Screening for family members of patients with nasopharyngeal carcinoma. Int J Cancer. 2005;113(6):998–1001.

    Article  CAS  PubMed  Google Scholar 

  23. Chan KC, Hung EC, Woo JK, Chan PK, Leung SF, Lai FP, et al. Early detection of nasopharyngeal carcinoma by plasma Epstein-Barr virus DNA analysis in a surveillance program. Cancer. 2013;119(10):1838–44.

    Article  CAS  PubMed  Google Scholar 

  24. Lin SY, Tsang NM, Kao SC, Hsieh YL, Chen YP, Tsai CS, et al. Presence of Epstein-Barr virus latent membrane protein 1 gene in the nasopharyngeal swabs from patients with nasopharyngeal carcinoma. Head Neck. 2001;23(3):194–200.

    Article  CAS  PubMed  Google Scholar 

  25. Ng RH, Ngan R, Wei WI, Gullane PJ, Phillips J. Trans-oral brush biopsies and quantitative PCR for EBV DNA detection and screening of nasopharyngeal carcinoma. Otolaryngol Head Neck Surg. 2014;150(4):602–9.

    Article  PubMed  Google Scholar 

  26. Liao XB, Mao YP, Liu LZ, Tang LL, Sun Y, Wang Y, et al. How does magnetic resonance imaging influence staging according to AJCC staging system for nasopharyngeal carcinoma compared with computed tomography? Int J Radiat Oncol Biol Phys. 2008;72(5):1368–77.

    Article  PubMed  Google Scholar 

  27. Chua ML, Ong SC, Wee JT, Ng DC, Gao F, Tan TW, et al. Comparison of 4 modalities for distant metastasis staging in endemic nasopharyngeal carcinoma. Head Neck. 2009;31(3):346–54.

    Article  PubMed  Google Scholar 

  28. Ng SH, Chan SC, Yen TC, Chang JT, Liao CT, Ko SF, et al. Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up. Eur J Nucl Med Mol Imaging. 2009;36(1):12–22.

    Article  PubMed  Google Scholar 

  29. King AD, Ma BB, Yau YY, Zee B, Leung SF, Wong JK, et al. The impact of 18F-FDG PET/CT on assessment of nasopharyngeal carcinoma at diagnosis. Br J Radiol. 2008;81(964):291–8.

    Article  CAS  PubMed  Google Scholar 

  30. Tang LQ, Chen QY, Fan W, Liu H, Zhang L, Guo L, et al. Prospective study of tailoring whole-body dual-modality [18F]fluorodeoxyglucose positron emission tomography/computed tomography with plasma Epstein-Barr virus DNA for detecting distant metastasis in endemic nasopharyngeal carcinoma at initial staging. J Clin Oncol. 2013;31(23):2861–9.

    Article  CAS  PubMed  Google Scholar 

  31. NCCN Treatment guidelines in Oncology: Head and Neck Cancers Version 1.2015 NCCN.org.

    Google Scholar 

  32. Chan AT, Gregoire V, Lefebvre JL, Licitra L, Hui EP, Leung SF, et al. Nasopharyngeal cancer: EHNS-ESMO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23 Suppl 7:vii83–5.

    Google Scholar 

  33. Mesic JB, Fletcher GH, Goepfert H. Megavoltage irradiation of epithelial tumors of the nasopharynx. Int J Radiat Oncol Biol Phys. 1981;7(4):447–53.

    Article  CAS  PubMed  Google Scholar 

  34. Perez CA, Devineni VR, Marcial-Vega V, Marks JE, Simpson JR, Kucik N. Carcinoma of the nasopharynx: factors affecting prognosis. Int J Radiat Oncol Biol Phys. 1992;23(2):271–80.

    Article  CAS  PubMed  Google Scholar 

  35. Teo PM, Leung SF, Tung SY, Zee B, Sham JS, Lee AW, et al. Dose-response relationship of nasopharyngeal carcinoma above conventional tumoricidal level: a study by the Hong Kong nasopharyngeal carcinoma study group (HKNPCSG). Radiother Oncol. 2006;79(1):27–33.

    Article  PubMed  Google Scholar 

  36. Lee AW, Chan DK, Fowler JF, Poon YF, Foo W, Law SC, et al. Effect of time, dose and fractionation on local control of nasopharyngeal carcinoma. Radiother Oncol. 1995;36(1):24–31.

    Article  CAS  PubMed  Google Scholar 

  37. Lee AW, Foo W, Chappell R, Fowler JF, Sze WM, Poon YF, et al. Effect of time, dose, and fractionation on temporal lobe necrosis following radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1998;40(1):35–42.

    Article  CAS  PubMed  Google Scholar 

  38. Lee AW, Kwong DL, Leung SF, Tung SY, Sze WM, Sham JS, et al. Factors affecting risk of symptomatic temporal lobe necrosis: significance of fractional dose and treatment time. Int J Radiat Oncol Biol Phys. 2002;53(1):75–85.

    Article  PubMed  Google Scholar 

  39. Leung TW, Wong VY, Sze WK, Lui CM, Tung SY. High-dose-rate intracavitary brachytherapy boost for early T stage nasopharyngeal carcinoma{private}. Int J Radiat Oncol Biol Phys. 2008;70(2):361–7.

    Article  PubMed  Google Scholar 

  40. Rosenblatt E, Abdel-Wahab M, El-Gantiry M, Elattar I, Bourque JM, Afiane M, et al. Brachytherapy boost in loco-regionally advanced nasopharyngeal carcinoma: a prospective randomized trial of the International Atomic Energy Agency. Radiat Oncol (Lond, Engl). 2014;9(1):67.

    Google Scholar 

  41. Hara W, Loo Jr BW, Goffinet DR, Chang SD, Adler JR, Pinto HA, et al. Excellent local control with stereotactic radiotherapy boost after external beam radiotherapy in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2008;71(2):393–400.

    Article  PubMed  Google Scholar 

  42. Lee AW, Ng WT, Hung WM, Choi CW, Tung R, Ling YH, et al. Major late toxicities after conformal radiotherapy for nasopharyngeal carcinoma-patient- and treatment-related risk factors. Int J Radiat Oncol Biol Phys. 2009;73(4):1121–8.

    Article  PubMed  Google Scholar 

  43. Kwong DL, Sham JS, Leung LH, Cheng AC, Ng WM, Kwong PW, et al. Preliminary results of radiation dose escalation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006;64(2):374–81.

    Article  PubMed  Google Scholar 

  44. Sun X, Su S, Chen C, Han F, Zhao C, Xiao W, et al. Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma: an analysis of survival and treatment toxicities. Radiother Oncol. 2014;110(3):398–403.

    Article  PubMed  Google Scholar 

  45. Bakst RL, Lee N, Pfister DG, Zelefsky MJ, Hunt MA, Kraus DH, et al. Hypofractionated dose-painting intensity modulated radiation therapy with chemotherapy for nasopharyngeal carcinoma: a prospective trial. Int J Radiat Oncol Biol Phys. 2011;80(1):148–53.

    Article  PubMed  Google Scholar 

  46. Vikram B, Mishra UB, Strong EW, Manolatos S. Patterns of failure in carcinoma of the nasopharynx: I. Failure at the primary site. Int J Radiat Oncol Biol Phys. 1985;11(8):1455–9.

    Article  CAS  PubMed  Google Scholar 

  47. Kwong DL, Nicholls J, Wei WI, Chua DT, Sham JS, Yuen PW, et al. The time course of histologic remission after treatment of patients with nasopharyngeal carcinoma. Cancer. 1999;85(7):1446–53.

    Article  CAS  PubMed  Google Scholar 

  48. Teo PM, Leung SF, Chan AT, Leung TW, Choi PH, Kwan WH, et al. Final report of a randomized trial on altered-fractionated radiotherapy in nasopharyngeal carcinoma prematurely terminated by significant increase in neurologic complications. Int J Radiat Oncol Biol Phys. 2000;48(5):1311–22.

    Article  CAS  PubMed  Google Scholar 

  49. Daoud J, Toumi N, Siala W, Ghorbel A, Drira MM, Frikha M. Results of a prospective randomised trial comparing conventional radiotherapy to split course bifractionated radiation therapy in patients with nasopharyngeal carcinoma. Radiother Oncol. 2007;85(1):17–23.

    Article  PubMed  Google Scholar 

  50. Pan ZQ, He XY, Guo XM, Ye M, Zhang Z, He SQ, et al. A phase III study of late course accelerated hyperfractionated radiotherapy versus conventionally fractionated radiotherapy in patients with nasopharyngeal carcinoma. Am J Clin Oncol. 2012;35(6):600–5.

    Article  PubMed  Google Scholar 

  51. Lee AW, Tung SY, Chan AT, Chappell R, Fu YT, Lu TX, et al. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2006;66(1):142–51.

    Article  PubMed  Google Scholar 

  52. Lee A, Ngan R, Tung S, et al. Preliminary results of NPC-0501 Trial to evaluate the therapeutic gain by changing chemoradiotherapy from concurrent-adjuvant to induction-concurrent sequence, and radiotherapy from conventional to accelerated fractionation for advanced nasopharyngeal carcinoma (NPC). Eur J Cancer. 2013;49(Supple 3):S12.

    Google Scholar 

  53. Daisne JF, Duprez T, Weynand B, Lonneux M, Hamoir M, Reychler H, et al. Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging, and FDG PET and validation with surgical specimen. Radiology. 2004;233(1):93–100.

    Article  PubMed  Google Scholar 

  54. Schinagl DA, Vogel WV, Hoffmann AL, van Dalen JA, Oyen WJ, Kaanders JH. Comparison of five segmentation tools for 18F-fluoro-deoxy-glucose-positron emission tomography-based target volume definition in head and neck cancer. Int J Radiat Oncol Biol Phys. 2007;69(4):1282–9.

    Article  CAS  PubMed  Google Scholar 

  55. Xia P, Fu KK, Wong GW, Akazawa C, Verhey LJ. Comparison of treatment plans involving intensity-modulated radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2000;48(2):329–37.

    Article  CAS  PubMed  Google Scholar 

  56. Cheng JC, Chao KS, Low D. Comparison of intensity modulated radiation therapy (IMRT) treatment techniques for nasopharyngeal carcinoma. Int J Cancer. 2001;96(2):126–31.

    Article  CAS  PubMed  Google Scholar 

  57. Hunt MA, Zelefsky MJ, Wolden S, Chui CS, LoSasso T, Rosenzweig K, et al. Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer. Int J Radiat Oncol Biol Phys. 2001;49(3):623–32.

    Article  CAS  PubMed  Google Scholar 

  58. Kam MK, Chau RM, Suen J, Choi PH, Teo PM. Intensity-modulated radiotherapy in nasopharyngeal carcinoma: dosimetric advantage over conventional plans and feasibility of dose escalation. Int J Radiat Oncol Biol Phys. 2003;56(1):145–57.

    Article  PubMed  Google Scholar 

  59. Lee AW, Sze H, Ng WT. Is selective neck irradiation safe for node-negative nasopharyngeal carcinoma? Int J Radiat Oncol Biol Phys. 2013;85(4):902–3.

    Article  PubMed  Google Scholar 

  60. Ng WT, Lee MC, Hung WM, Choi CW, Lee KC, Chan OS, et al. Clinical outcomes and patterns of failure after intensity-modulated radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2011;79(2):420–8.

    Article  PubMed  Google Scholar 

  61. Peng G, Wang T, Yang KY, Zhang S, Zhang T, Li Q, et al. A prospective, randomized study comparing outcomes and toxicities of intensity-modulated radiotherapy vs. conventional two-dimensional radiotherapy for the treatment of nasopharyngeal carcinoma. Radiother Oncol. 2012;104(3):286–93.

    Article  PubMed  Google Scholar 

  62. Pow EH, Kwong DL, McMillan AS, Wong MC, Sham JS, Leung LH, et al. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys. 2006;66(4):981–91.

    Article  PubMed  Google Scholar 

  63. Kam MK, Leung SF, Zee B, Chau RM, Suen JJ, Mo F, et al. Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol. 2007;25(31):4873–9.

    Article  PubMed  Google Scholar 

  64. Ng WT, Lee MC, Chang AT, Chan OS, Chan LL, Cheung FY, et al. The impact of dosimetric inadequacy on treatment outcome of nasopharyngeal carcinoma with IMRT. Oral Oncol. 2014;50(5):506–12.

    Article  PubMed  Google Scholar 

  65. Barker Jr JL, Garden AS, Ang KK, O’Daniel JC, Wang H, Court LE, et al. Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT/linear accelerator system. Int J Radiat Oncol Biol Phys. 2004;59(4):960–70.

    Article  PubMed  Google Scholar 

  66. Hansen EK, Bucci MK, Quivey JM, Weinberg V, Xia P. Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2006;64(2):355–62.

    Article  PubMed  Google Scholar 

  67. Cheng HC, Wu VW, Ngan RK, Tang KW, Chan CC, Wong KH, et al. A prospective study on volumetric and dosimetric changes during intensity-modulated radiotherapy for nasopharyngeal carcinoma patients. Radiother Oncol. 2012;104(3):317–23.

    Article  PubMed  Google Scholar 

  68. Yang H, Hu W, Wang W, Chen P, Ding W, Luo W. Replanning during intensity modulated radiation therapy improved quality of life in patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2013;85(1):e47–54.

    Article  PubMed  Google Scholar 

  69. Zhao L, Wan Q, Zhou Y, Deng X, Xie C, Wu S. The role of replanning in fractionated intensity modulated radiotherapy for nasopharyngeal carcinoma. Radiother Oncol. 2011;98(1):23–7.

    Article  PubMed  Google Scholar 

  70. Wang W, Yang H, Hu W, Shan G, Ding W, Yu C, et al. Clinical study of the necessity of replanning before the 25th fraction during the course of intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2010;77(2):617–21.

    Article  PubMed  Google Scholar 

  71. Fiorino C, Dell’Oca I, Pierelli A, Broggi S, Cattaneo GM, Chiara A, et al. Simultaneous integrated boost (SIB) for nasopharynx cancer with helical tomotherapy. A planning study. Strahlentherapie und Onkologie: Organ der Deutschen Rontgengesellschaft [et al.]. 2007;183(9):497–505.

    Google Scholar 

  72. Lee TF, Fang FM, Chao PJ, Su TJ, Wang LK, Leung SW. Dosimetric comparisons of helical tomotherapy and step-and-shoot intensity-modulated radiotherapy in nasopharyngeal carcinoma. Radiother Oncol. 2008;89(1):89–96.

    Article  PubMed  Google Scholar 

  73. Lee FK, Yip CW, Cheung FC, Leung AK, Chau RM, Ngan RK. Dosimetric difference amongst 3 techniques: TomoTherapy, sliding-window intensity-modulated radiotherapy (IMRT), and RapidArc radiotherapy in the treatment of late-stage nasopharyngeal carcinoma (NPC). Med Dosim. 2014;39(1):44–9.

    Article  PubMed  Google Scholar 

  74. Rong Y, Chen Y, Shang L, Zuo L, Lu W, Chen Q. Helical tomotherapy with dynamic running-start-stop delivery compared to conventional tomotherapy delivery. Med Phys. 2014;41(5):051709.

    Article  PubMed  Google Scholar 

  75. Taheri-Kadkhoda Z, Bjork-Eriksson T, Nill S, Wilkens JJ, Oelfke U, Johansson KA, et al. Intensity-modulated radiotherapy of nasopharyngeal carcinoma: a comparative treatment planning study of photons and protons. Radiat Oncol (Lond, Engl). 2008;3:4.

    Google Scholar 

  76. Widesott L, Pierelli A, Fiorino C, Dell’oca I, Broggi S, Cattaneo GM, et al. Intensity-modulated proton therapy versus helical tomotherapy in nasopharynx cancer: planning comparison and NTCP evaluation. Int J Radiat Oncol Biol Phys. 2008;72(2):589–96.

    Article  PubMed  Google Scholar 

  77. Liu SW, Li JM, Chang JY, Yu JM, Chen Q, Jiang QA, et al. A treatment planning comparison between proton beam therapy and intensity-modulated x-ray therapy for recurrent nasopharyngeal carcinoma. J Xray Sci Technol. 2010;18(4):443–50.

    CAS  PubMed  Google Scholar 

  78. Chan A, Liebsch L, Deschler D, et al. Proton radiotherapy for T4 nasopharyngeal carcinoma. J Clin Oncol. 2004;22(14 Suppl):5574.

    Google Scholar 

  79. Chan A, Adams JA, Weyman E, et al. A phase II trial of proton radiation therapy with chemotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2012;84:S151–2.

    Article  Google Scholar 

  80. Lin R, Slater JD, Yonemoto LT, Grove RI, Teichman SL, Watt DK, et al. Nasopharyngeal carcinoma: repeat treatment with conformal proton therapy—dose-volume histogram analysis. Radiology. 1999;213(2):489–94.

    Article  CAS  PubMed  Google Scholar 

  81. Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998;16(4):1310–7.

    CAS  PubMed  Google Scholar 

  82. Al-Sarraf M, LeBlanc M, Giri PG, et al. Superiority of five year survival with chemoradiotherapy (CT-radiotherapy) vs radiotherapy in patients (Pts) with locally advanced nasopharyngeal cancer (NPC). Intergroup (0099) (SWOG 8892, RTOG 8817, ECOG 2388) phase III study: final report. Proc Am Soc Clin Oncol 20; Abstract 905.

    Google Scholar 

  83. Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, et al. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC-9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol. 2005;23(28):6966–75.

    Article  CAS  PubMed  Google Scholar 

  84. Lee AW, Tung SY, Chua DT, Ngan RK, Chappell R, Tung R, et al. Randomized trial of radiotherapy plus concurrent-adjuvant chemotherapy vs radiotherapy alone for regionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst. 2010;102(15):1188–98.

    Article  PubMed  Google Scholar 

  85. Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, et al. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol. 2005;23(27):6730–8.

    Article  CAS  PubMed  Google Scholar 

  86. Wee 4th J. FY Khoo Memorial Lecture 2008: Nasopharyngeal Cancer Workgroup—the past, the present and the future. Ann Acad Med Singapore. 2008;37(7):606–14.

    PubMed  Google Scholar 

  87. Chen Y, Liu MZ, Liang SB, Zong JF, Mao YP, Tang LL, et al. Preliminary results of a prospective randomized trial comparing concurrent chemoradiotherapy plus adjuvant chemotherapy with radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma in endemic regions of china. Int J Radiat Oncol Biol Phys. 2008;71(5):1356–64.

    Article  PubMed  Google Scholar 

  88. Chen Y, Sun Y, Liang SB, Zong JF, Li WF, Chen M, et al. Progress report of a randomized trial comparing long-term survival and late toxicity of concurrent chemoradiotherapy with adjuvant chemotherapy versus radiotherapy alone in patients with stage III to IVB nasopharyngeal carcinoma from endemic regions of China. Cancer. 2013;119(12):2230–8.

    Article  CAS  PubMed  Google Scholar 

  89. Chan AT, Teo PM, Ngan RK, Leung TW, Lau WH, Zee B, et al. Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial. J Clin Oncol. 2002;20(8):2038–44.

    Article  CAS  PubMed  Google Scholar 

  90. Chan AT, Leung SF, Ngan RK, Teo PM, Lau WH, Kwan WH, et al. Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst. 2005;97(7):536–9.

    Article  CAS  PubMed  Google Scholar 

  91. Lin JC, Jan JS, Hsu CY, Liang WM, Jiang RS, Wang WY. Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival. J Clin Oncol. 2003;21(4):631–7.

    Article  PubMed  Google Scholar 

  92. Lin JC, Liang WM, Jan JS, Jiang RS, Lin AC. Another way to estimate outcome of advanced nasopharyngeal carcinoma—is concurrent chemoradiotherapy adequate? Int J Radiat Oncol Biol Phys. 2004;60(1):156–64.

    Article  PubMed  Google Scholar 

  93. Kwong DL, Sham JS, Au GK, Chua DT, Kwong PW, Cheng AC, et al. Concurrent and adjuvant chemotherapy for nasopharyngeal carcinoma: a factorial study. J Clin Oncol. 2004;22(13):2643–53.

    Article  CAS  PubMed  Google Scholar 

  94. Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data meta-analysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys. 2006;64(1):47–56.

    Article  CAS  PubMed  Google Scholar 

  95. Chan AT, Teo PM, Leung TW, Leung SF, Lee WY, Yeo W, et al. A prospective randomized study of chemotherapy adjunctive to definitive radiotherapy in advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1995;33(3):569–77.

    Article  CAS  PubMed  Google Scholar 

  96. Chua DT, Sham JS, Choy D, Lorvidhaya V, Sumitsawan Y, Thongprasert S, et al. Preliminary report of the Asian-Oceanian Clinical Oncology Association randomized trial comparing cisplatin and epirubicin followed by radiotherapy versus radiotherapy alone in the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. Asian-Oceanian Clinical Oncology Association Nasopharynx Cancer Study Group. Cancer. 1998;83(11):2270–83.

    Article  CAS  PubMed  Google Scholar 

  97. International Nasopharynx Cancer Study Group. Preliminary results of a randomized trial comparing neoadjuvant chemotherapy (cisplatin, epirubicin, bleomycin) plus radiotherapy vs. radiotherapy alone in stage IV(> or = N2, M0) undifferentiated nasopharyngeal carcinoma: a positive effect on progression-free survival. Int J Radiat Oncol Biol Phys. 1996;35(3):463–9.

    Google Scholar 

  98. Hareyama M, Sakata K, Shirato H, Nishioka T, Nishio M, Suzuki K, et al. A prospective, randomized trial comparing neoadjuvant chemotherapy with radiotherapy alone in patients with advanced nasopharyngeal carcinoma. Cancer. 2002;94(8):2217–23.

    Article  CAS  PubMed  Google Scholar 

  99. Chi KH, Chang YC, Guo WY, Leung MJ, Shiau CY, Chen SY, et al. A phase III study of adjuvant chemotherapy in advanced nasopharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys. 2002;52(5):1238–44.

    Article  CAS  PubMed  Google Scholar 

  100. Chen L, Hu CS, Chen XZ, Hu GQ, Cheng ZB, Sun Y, et al. Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial. Lancet Oncol. 2012;13(2):163–71.

    Article  PubMed  Google Scholar 

  101. Meta-analysis of chemotherapy in nasopharyngeal carcinoma (MAC-NPC): an update on 4,798 patients. J Clin Oncol. 2014;32:5s (suppl; abstr 6022).

    Google Scholar 

  102. Chen QY, Wen YF, Guo L, Liu H, Huang PY, Mo HY, et al. Concurrent chemoradiotherapy vs radiotherapy alone in stage II nasopharyngeal carcinoma: phase III randomized trial. J Natl Cancer Inst. 2011;103(23):1761–70.

    Article  PubMed  Google Scholar 

  103. Zhang L, Zhao C, Peng PJ, Lu LX, Huang PY, Han F, et al. Phase III study comparing standard radiotherapy with or without weekly oxaliplatin in treatment of locoregionally advanced nasopharyngeal carcinoma: preliminary results. J Clin Oncol. 2005;23(33):8461–8.

    Article  CAS  PubMed  Google Scholar 

  104. Wu X, Huang PY, Peng PJ, Lu LX, Han F, Wu SX, et al. Long-term follow-up of a phase III study comparing radiotherapy with or without weekly oxaliplatin for locoregionally advanced nasopharyngeal carcinoma. Ann Oncol. 2013;24(8):2131–6.

    Article  CAS  PubMed  Google Scholar 

  105. Lee AW, Tung SY, Ngan RK, Chappell R, Chua DT, Lu TX, et al. Factors contributing to the efficacy of concurrent-adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma: combined analyses of NPC-9901 and NPC-9902 Trials. Eur J Cancer. 2011;47(5):656–66.

    Article  CAS  PubMed  Google Scholar 

  106. Lee AW, Lau KY, Hung WM, Ng WT, Lee MC, Choi CW, et al. Potential improvement of tumor control probability by induction chemotherapy for advanced nasopharyngeal carcinoma. Radiother Oncol. 2008;87(2):204–10.

    Article  CAS  PubMed  Google Scholar 

  107. Rischin D, Corry J, Smith J, Stewart J, Hughes P, Peters L. Excellent disease control and survival in patients with advanced nasopharyngeal cancer treated with chemoradiation. J Clin Oncol. 2002;20(7):1845–52.

    Article  CAS  PubMed  Google Scholar 

  108. Hui EP, Ma BB, Leung SF, King AD, Mo F, Kam MK, et al. Randomized phase II trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasopharyngeal carcinoma. J Clin Oncol. 2009;27(2):242–9.

    Article  CAS  PubMed  Google Scholar 

  109. Fountzilas G, Ciuleanu E, Bobos M, Kalogera-Fountzila A, Eleftheraki AG, Karayannopoulou G, et al. Induction chemotherapy followed by concomitant radiotherapy and weekly cisplatin versus the same concomitant chemoradiotherapy in patients with nasopharyngeal carcinoma: a randomized phase II study conducted by the Hellenic Cooperative Oncology Group (HeCOG) with biomarker evaluation. Ann Oncol. 2012;23(2):427–35.

    Article  CAS  PubMed  Google Scholar 

  110. Tan T, Lim WT, Fong KW, et al. Randomized phase III trial of concurrent chemoradiation with or without neoadjuvant gemcitabine, carboplatin, and paclitaxel in locally advanced nasopharyngeal cancer. J Clin Oncol. 2014;32:5s(suppl; abstr 6003).

    Google Scholar 

  111. Bourhis J, Sire C, Graff P, Gregoire V, Maingon P, Calais G, et al. Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99-02): an open-label phase 3 randomised trial. Lancet Oncol. 2012;13(2):145–53.

    Article  PubMed  Google Scholar 

  112. Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tan PF, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363(1):24–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  113. Liu T, Xu W, Yan WL, Ye M, Bai YR, Huang G. FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol. 2007;85(3):327–35.

    Article  PubMed  Google Scholar 

  114. Chan AT, Lo YM, Zee B, Chan LY, Ma BB, Leung SF, et al. Plasma Epstein-Barr virus DNA and residual disease after radiotherapy for undifferentiated nasopharyngeal carcinoma. J Natl Cancer Inst. 2002;94(21):1614–9.

    Article  CAS  PubMed  Google Scholar 

  115. Lin JC, Wang WY, Liang WM, Chou HY, Jan JS, Jiang RS, et al. Long-term prognostic effects of plasma epstein-barr virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2007;68(5):1342–8.

    Article  CAS  PubMed  Google Scholar 

  116. Le QT, Jones CD, Yau TK, Shirazi HA, Wong PH, Thomas EN, et al. A comparison study of different PCR assays in measuring circulating plasma epstein-barr virus DNA levels in patients with nasopharyngeal carcinoma. Clin Can Res. 2005;11(16):5700–7.

    Article  CAS  Google Scholar 

  117. Chan AT, Ma BB, Lo YM, Leung SF, Kwan WH, Hui EP, et al. Phase II study of neoadjuvant carboplatin and paclitaxel followed by radiotherapy and concurrent cisplatin in patients with locoregionally advanced nasopharyngeal carcinoma: therapeutic monitoring with plasma Epstein-Barr virus DNA. J Clin Oncol. 2004;22(15):3053–60.

    Article  CAS  PubMed  Google Scholar 

  118. Kwong DL, Wei WI, Cheng AC, Choy DT, Lo AT, Wu PM, et al. Long term results of radioactive gold grain implantation for the treatment of persistent and recurrent nasopharyngeal carcinoma. Cancer. 2001;91(6):1105–13.

    Article  CAS  PubMed  Google Scholar 

  119. Law SC, Lam WK, Ng MF, Au SK, Mak WT, Lau WH. Reirradiation of nasopharyngeal carcinoma with intracavitary mold brachytherapy: an effective means of local salvage. Int J Radiat Oncol Biol Phys. 2002;54(4):1095–113.

    Article  PubMed  Google Scholar 

  120. Yau TK, Sze WM, Lee WM, Yeung MW, Leung KC, Hung WM, et al. Effectiveness of brachytherapy and fractionated stereotactic radiotherapy boost for persistent nasopharyngeal carcinoma. Head Neck. 2004;26(12):1024–30.

    Article  PubMed  Google Scholar 

  121. Leung TW, Tung SY, Sze WK, Sze WM, Wong VY, O SK. Salvage brachytherapy for patients with locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2000;47(2):405–12.

    Article  CAS  PubMed  Google Scholar 

  122. Zheng XK, Chen LH, Chen YQ, Deng XG. Three-dimensional conformal radiotherapy versus intracavitary brachytherapy for salvage treatment of locally persistent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2004;60(1):165–70.

    Article  PubMed  Google Scholar 

  123. Wu SX, Chua DT, Deng ML, Zhao C, Li FY, Sham JS, et al. Outcome of fractionated stereotactic radiotherapy for 90 patients with locally persistent and recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2007;69(3):761–9.

    Article  PubMed  Google Scholar 

  124. Cmelak AJ, Cox RS, Adler JR, Fee Jr WE, Goffinet DR. Radiosurgery for skull base malignancies and nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 1997;37(5):997–1003.

    Article  CAS  PubMed  Google Scholar 

  125. Chua DT, Sham JS, Hung KN, Leung LH, Cheng PW, Kwong PW. Salvage treatment for persistent and recurrent T1-2 nasopharyngeal carcinoma by stereotactic radiosurgery. Head Neck. 2001;23(9):791–8.

    Article  CAS  PubMed  Google Scholar 

  126. Lee AW, Law SC, Foo W, Poon YF, Cheung FK, Chan DK, et al. Retrospective analysis of patients with nasopharyngeal carcinoma treated during 1976–1985: survival after local recurrence. Int J Radiat Oncol Biol Phys. 1993;26(5):773–82.

    Article  CAS  PubMed  Google Scholar 

  127. Fisch U. The infratemporal fossa approach for nasopharyngeal tumors. Laryngoscope. 1983;93(1):36–44.

    Article  CAS  PubMed  Google Scholar 

  128. Fee Jr WE, Roberson Jr JB, Goffinet DR. Long-term survival after surgical resection for recurrent nasopharyngeal cancer after radiotherapy failure. Arch Otolaryngol Head Neck Surg. 1991;117(11):1233–6.

    Article  PubMed  Google Scholar 

  129. Morton RP, Liavaag PG, McLean M, Freeman JL. Transcervico-mandibulo-palatal approach for surgical salvage of recurrent nasopharyngeal cancer. Head Neck. 1996;18(4):352–8.

    Article  CAS  PubMed  Google Scholar 

  130. Chan JY, Chow VL, Tsang R, Wei WI. Nasopharyngectomy for locally advanced recurrent nasopharyngeal carcinoma: exploring the limits. Head Neck. 2012;34(7):923–8.

    Article  PubMed  Google Scholar 

  131. Tsang RK, Ho WK, Wei WI, Chan JY. Transoral robotic assisted nasopharyngectomy via a lateral palatal flap approach. Laryngoscope. 2013;123(9):2180–3.

    Article  PubMed  Google Scholar 

  132. Chan JY, Wei WI. Critical appraisal of maxillary swing approach for nasopharyngeal carcinoma. Expert Opin Ther Targets. 2012;16 Suppl 1:S111–7.

    Article  PubMed  Google Scholar 

  133. Chan JY, To VS, Chow VL, Wong ST, Wei WI. Multivariate analysis of prognostic factors for salvage nasopharyngectomy via the maxillary swing approach. Head Neck. 2014;36(7):1013–7.

    Article  PubMed  Google Scholar 

  134. Chan JY, Wong ST, Wei WI. Whole-organ histopathological study of recurrent nasopharyngeal carcinoma. Laryngoscope. 2014;124(2):446–50.

    Article  PubMed  Google Scholar 

  135. Chan JY, Tsang RK, Wei WI. Morbidities after maxillary swing nasopharyngectomy for recurrent nasopharyngeal carcinoma. Head Neck. 2014. doi:10.1002/hed.23633.

    Google Scholar 

  136. Chan YW, Chow VL, Wei WI. Quality of life of patients after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Cancer. 2012;118(15):3710–8.

    Article  PubMed  Google Scholar 

  137. Wei WI, Ho WK, Cheng AC, Wu X, Li GK, Nicholls J, et al. Management of extensive cervical nodal metastasis in nasopharyngeal carcinoma after radiotherapy: a clinicopathological study. Arch Otolaryngol Head Neck Surg. 2001;127(12):1457–62.

    Article  CAS  PubMed  Google Scholar 

  138. Chan YW, Lee VH, Chow VL, To VS, Wei WI. Extracapsular lymph node spread in recurrent nasopharyngeal carcinoma. Laryngoscope. 2011;121(12):2576–80.

    Article  PubMed  Google Scholar 

  139. Yu KH, Leung SF, Tung SY, Zee B, Chua DT, Sze WM, et al. Survival outcome of patients with nasopharyngeal carcinoma with first local failure: a study by the Hong Kong Nasopharyngeal Carcinoma Study Group. Head Neck. 2005;27(5):397–405.

    Article  PubMed  Google Scholar 

  140. Tian YM, Tian YH, Zeng L, Liu S, Guan Y, Lu TX, et al. Prognostic model for survival of local recurrent nasopharyngeal carcinoma with intensity-modulated radiotherapy. Br J Cancer. 2014;110(2):297–303.

    Article  PubMed  Google Scholar 

  141. Pryzant RM, Wendt CD, Delclos L, Peters LJ. Re-treatment of nasopharyngeal carcinoma in 53 patients. Int J Radiat Oncol Biol Phys. 1992;22(5):941–7.

    Article  CAS  PubMed  Google Scholar 

  142. Lee AW, Foo W, Law SC, Poon YF, Sze WM, O SK, et al. Reirradiation for recurrent nasopharyngeal carcinoma: factors affecting the therapeutic ratio and ways for improvement. Int J Radiat Oncol Biol Phys. 1997;38(1):43–52.

    Article  CAS  PubMed  Google Scholar 

  143. Liu S, Lu T, Zhao C, Shen J, Tian Y, Guan Y, et al. Temporal lobe injury after re-irradiation of locally recurrent nasopharyngeal carcinoma using intensity modulated radiotherapy: clinical characteristics and prognostic factors. J Neurooncol. 2014;119(2):421–8.

    Article  CAS  PubMed  Google Scholar 

  144. Chen HY, Ma XM, Ye M, Hou YL, Xie HY, Bai YR. Effectiveness and toxicities of intensity-modulated radiotherapy for patients with locally recurrent nasopharyngeal carcinoma. PLoS One. 2013;8(9), e73918.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  145. Han F, Zhao C, Huang SM, Lu LX, Huang Y, Deng XW, et al. Long-term outcomes and prognostic factors of re-irradiation for locally recurrent nasopharyngeal carcinoma using intensity-modulated radiotherapy. Clin Oncol (R Coll Radiol). 2012;24(8):569–76.

    Google Scholar 

  146. Lee AW, Foo W, Law SC, Peters LJ, Poon YF, Chappell R, et al. Total biological effect on late reactive tissues following reirradiation for recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2000;46(4):865–72.

    Article  CAS  PubMed  Google Scholar 

  147. Leung TW, Tung SY, Sze WK, Sze WM, Wong VY, Wong CS, et al. Salvage radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2000;48(5):1331–8.

    Article  CAS  PubMed  Google Scholar 

  148. Chen HJ, Leung SW, Su CY. Linear accelerator based radiosurgery as a salvage treatment for skull base and intracranial invasion of recurrent nasopharyngeal carcinomas. Am J Clin Oncol. 2001;24(3):255–8.

    Article  CAS  PubMed  Google Scholar 

  149. Chua DT, Sham JS, Hung KN, Kwong DL, Kwong PW, Leung LH. Stereotactic radiosurgery as a salvage treatment for locally persistent and recurrent nasopharyngeal carcinoma. Head Neck. 1999;21(7):620–6.

    Article  CAS  PubMed  Google Scholar 

  150. Pai PC, Chuang CC, Wei KC, Tsang NM, Tseng CK, Chang CN. Stereotactic radiosurgery for locally recurrent nasopharyngeal carcinoma. Head Neck. 2002;24(8):748–53.

    Article  PubMed  Google Scholar 

  151. Leung TW, Wong VY, Tung SY. Stereotactic radiotherapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2009;75(3):734–41.

    Article  PubMed  Google Scholar 

  152. Chua DT, Wei WI, Sham JS, Hung KN, Au GK. Stereotactic radiosurgery versus gold grain implantation in salvaging local failures of nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2007;69(2):469–74.

    Article  PubMed  Google Scholar 

  153. Chang JT, See LC, Liao CT, Ng SH, Wang CH, Chen IH, et al. Locally recurrent nasopharyngeal carcinoma. Radiother Oncol. 2000;54(2):135–42.

    Article  CAS  PubMed  Google Scholar 

  154. Xiao J, Xu G, Miao Y. Fractionated stereotactic radiosurgery for 50 patients with recurrent or residual nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2001;51(1):164–70.

    Article  CAS  PubMed  Google Scholar 

  155. Chua DT, Wu SX, Lee V, Tsang J. Comparison of single versus fractionated dose of stereotactic radiotherapy for salvaging local failures of nasopharyngeal carcinoma: a matched-cohort analysis. Head Neck Oncol. 2009;1:13.

    Article  PubMed  PubMed Central  Google Scholar 

  156. Seo Y, Yoo H, Yoo S, Cho C, Yang K, Kim MS, et al. Robotic system-based fractionated stereotactic radiotherapy in locally recurrent nasopharyngeal carcinoma. Radiother Oncol. 2009;93(3):570–4.

    Article  PubMed  Google Scholar 

  157. Ozyigit G, Cengiz M, Yazici G, Yildiz F, Gurkaynak M, Zorlu F, et al. 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. 2011;81(4):e263–8.

    Article  PubMed  Google Scholar 

  158. Zou X, Han F, Ma WJ, Deng MQ, Jiang R, Guo L, et al. Salvage endoscopic nasopharyngectomy and intensity-modulated radiation therapy (IMRT) versus conventional radiotherapy in treating locally recurrent nasopharyngeal carcinoma. Head Neck. 2014.

    Google Scholar 

  159. Tian YM, Zhao C, Guo Y, Huang Y, Huang SM, Deng XW, et al. 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. 2014;120(22):3502–9.

    Article  PubMed  Google Scholar 

  160. Chua DT, Sham JS, Au GK. Induction chemotherapy with cisplatin and gemcitabine followed by reirradiation for locally recurrent nasopharyngeal carcinoma. Am J Clin Oncol. 2005;28(5):464–71.

    Article  CAS  PubMed  Google Scholar 

  161. Poon D, Yap SP, Wong ZW, Cheung YB, Leong SS, Wee J, et al. Concurrent chemoradiotherapy in locoregionally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2004;59(5):1312–8.

    Article  PubMed  Google Scholar 

  162. Koutcher L, Lee N, Zelefsky M, Chan K, Cohen G, Pfister D, et al. Reirradiation of locally recurrent nasopharynx cancer with external beam radiotherapy with or without brachytherapy. Int J Radiat Oncol Biol Phys. 2010;76(1):130–7.

    Article  PubMed  Google Scholar 

  163. Toh CK, Heng D, Ong YK, Leong SS, Wee J, Tan EH. Validation of a new prognostic index score for disseminated nasopharyngeal carcinoma. Br J Cancer. 2005;92(8):1382–7.

    Article  PubMed  PubMed Central  Google Scholar 

  164. Wang TL, Tan YO. Cisplatin and 5-fluorouracil continuous infusion for metastatic nasopharyngeal carcinoma. Ann Acad Med Singapore. 1991;20(5):601–3.

    CAS  PubMed  Google Scholar 

  165. Au E, Ang PT. A phase II trial of 5-fluorouracil and cisplatinum in recurrent or metastatic nasopharyngeal carcinoma. Ann Oncol. 1994;5(1):87–9.

    CAS  PubMed  Google Scholar 

  166. Chi KH, Chan WK, Cooper DL, Yen SH, Lin CZ, Chen KY. A phase II study of outpatient chemotherapy with cisplatin, 5-fluorouracil, and leucovorin in nasopharyngeal carcinoma. Cancer. 1994;73(2):247–52.

    Article  CAS  PubMed  Google Scholar 

  167. Yeo W, Leung TW, Leung SF, Teo PM, Chan AT, Lee WY, et al. Phase II study of the combination of carboplatin and 5-fluorouracil in metastatic nasopharyngeal carcinoma. Cancer Chemother Pharmacol. 1996;38(5):466–70.

    Article  CAS  PubMed  Google Scholar 

  168. Siu LL, Czaykowski PM, Tannock IF. Phase I/II study of the CAPABLE regimen for patients with poorly differentiated carcinoma of the nasopharynx. J Clin Oncol. 1998;16(7):2514–21.

    CAS  PubMed  Google Scholar 

  169. Hasbini A, Mahjoubi R, Fandi A, Chouaki N, Taamma A, Lianes P, et al. Phase II trial combining mitomycin with 5-fluorouracil, epirubicin, and cisplatin in recurrent and metastatic undifferentiated carcinoma of nasopharyngeal type. Ann Oncol. 1999;10(4):421–5.

    Article  CAS  PubMed  Google Scholar 

  170. Chua DT, Sham JS, Au GK. A phase II study of docetaxel and cisplatin as first-line chemotherapy in patients with metastatic nasopharyngeal carcinoma. Oral Oncol. 2005;41(6):589–95.

    Article  CAS  PubMed  Google Scholar 

  171. Li YH, Wang FH, Jiang WQ, Xiang XJ, Deng YM, Hu GQ, et al. Phase II study of capecitabine and cisplatin combination as first-line chemotherapy in Chinese patients with metastatic nasopharyngeal carcinoma. Cancer Chemother Pharmacol. 2008;62(3):539–44.

    Article  CAS  PubMed  Google Scholar 

  172. Chua DT, Yiu HH, Seetalarom K, Ng AW, Kurnianda J, Shotelersuk K, et al. Phase II trial of capecitabine plus cisplatin as first-line therapy in patients with metastatic nasopharyngeal cancer. Head Neck. 2012;34(9):1225–30.

    Article  PubMed  Google Scholar 

  173. Ngan RK, Yiu HH, Lau WH, Yau S, Cheung FY, Chan TM, et al. Combination gemcitabine and cisplatin chemotherapy for metastatic or recurrent nasopharyngeal carcinoma: report of a phase II study. Ann Oncol. 2002;13(8):1252–8.

    Article  CAS  PubMed  Google Scholar 

  174. McCarthy JS, Tannock IF, Degendorfer P, Panzarella T, Furlan M, Siu LL. A Phase II trial of docetaxel and cisplatin in patients with recurrent or metastatic nasopharyngeal carcinoma. Oral Oncol. 2002;38(7):686–90.

    Article  CAS  PubMed  Google Scholar 

  175. Leong SS, Wee J, Rajan S, Toh CK, Lim WT, Hee SW, et al. Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal carcinoma. Cancer. 2008;113(6):1332–7.

    Article  CAS  PubMed  Google Scholar 

  176. Chan AT, Hsu MM, Goh BC, Hui EP, Liu TW, Millward MJ, et al. Multicenter, phase II study of cetuximab in combination with carboplatin in patients with recurrent or metastatic nasopharyngeal carcinoma. J Clin oncol. 2005;23(15):3568–76.

    Article  CAS  PubMed  Google Scholar 

  177. Elser C, Siu LL, Winquist E, Agulnik M, Pond GR, Chin SF, et al. Phase II trial of sorafenib in patients with recurrent or metastatic squamous cell carcinoma of the head and neck or nasopharyngeal carcinoma. J Clin Oncol. 2007;25(24):3766–73.

    Article  CAS  PubMed  Google Scholar 

  178. Chua DT, Wei WI, Wong MP, Sham JS, Nicholls J, Au GK. Phase II study of gefitinib for the treatment of recurrent and metastatic nasopharyngeal carcinoma. Head Neck. 2008;30(7):863–7.

    Article  PubMed  Google Scholar 

  179. You B, Le Tourneau C, Chen EX, Wang L, Jarvi A, Bharadwaj RR, et al. A Phase II trial of erlotinib as maintenance treatment after gemcitabine plus platinum-based chemotherapy in patients with recurrent and/or metastatic nasopharyngeal carcinoma. Am J Clin Oncol. 2012;35(3):255–60.

    Article  CAS  PubMed  Google Scholar 

  180. Ma B, Hui EP, King A, To KF, Mo F, Leung SF, et al. A phase II study of patients with metastatic or locoregionally recurrent nasopharyngeal carcinoma and evaluation of plasma Epstein-Barr virus DNA as a biomarker of efficacy. Cancer Chemother Pharmacol. 2008;62(1):59–64.

    Article  CAS  PubMed  Google Scholar 

  181. Hui EP, Ma BB, King AD, Mo F, Chan SL, Kam MK, et al. Hemorrhagic complications in a phase II study of sunitinib in patients of nasopharyngeal carcinoma who has previously received high-dose radiation. Ann Oncol. 2011;22(6):1280–7.

    Article  CAS  PubMed  Google Scholar 

  182. Lim WT, Ng QS, Ivy P, Leong SS, Singh O, Chowbay B, et al. A Phase II study of pazopanib in Asian patients with recurrent/metastatic nasopharyngeal carcinoma. Clin Cancer Res. 2011;17(16):5481–9.

    Article  CAS  PubMed  Google Scholar 

  183. Hoistad DL, Ondrey FG, Mutlu C, Schachern PA, Paparella MM, Adams GL. Histopathology of human temporal bone after cis-platinum, radiation, or both. Otolaryngol Head Neck Surg. 1998;118(6):825–32.

    Article  CAS  PubMed  Google Scholar 

  184. Chan SH, Ng WT, Kam KL, Lee MC, Choi CW, Yau TK, et al. Sensorineural hearing loss after treatment of nasopharyngeal carcinoma: a longitudinal analysis. Int J Radiat Oncol Biol Phys. 2009;73(5):1335–42.

    Article  CAS  PubMed  Google Scholar 

  185. Low WK, Gopal K, Goh LK, Fong KW. Cochlear implantation in postirradiated ears: outcomes and challenges. Laryngoscope. 2006;116(7):1258–62.

    Article  PubMed  Google Scholar 

  186. Soh JM, D’Souza VD, Sarepaka GK, Ng WN, Ong CS, Low WK. Cochlear implant outcomes: a comparison between irradiated and non-irradiated ears. Clin Exp Otorhinolaryngol. 2012;5 Suppl 1:S93–8.

    Article  PubMed  PubMed Central  Google Scholar 

  187. Formanek M, Czerny C, Gstoettner W, Kornfehl J. Cochlear implantation as a successful rehabilitation for radiation-induced deafness. Eur Arch Otorhinolaryngol. 1998;255(4):175–8.

    Article  CAS  PubMed  Google Scholar 

  188. Zhou X, Ou X, Xu T, Wang X, Shen C, Ding J, et al. 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. 2014;90(2):261–9.

    Article  PubMed  Google Scholar 

  189. Chen J, Dassarath M, Yin Z, Liu H, Yang K, Wu G. Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management. Radiat Oncol. 2011;6:128.

    Google Scholar 

  190. Lam TC, Wong FC, Leung TW, Ng SH, Tung SY. Clinical outcomes of 174 nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis. Int J Radiat Oncol Biol Phys. 2012;82(1):e57–65.

    Article  PubMed  Google Scholar 

  191. Mou YG, Sai K, Wang ZN, Zhang XH, Lu YC, Wei DN, et al. Surgical management of radiation-induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: report of 14 cases. Head Neck. 2011;33(10):1493–500.

    Article  PubMed  Google Scholar 

  192. Wong ST, Loo KT, Yam KY, Hung WM, Fok KF, Yuen SC, et al. Results of excision of cerebral radionecrosis: experience in patients treated with radiation therapy for nasopharyngeal carcinoma. J Neurosurg. 2010;113(2):293–300.

    Article  PubMed  Google Scholar 

  193. Cheng KM, Chan CM, Fu YT, Ho LC, Tsang YW, Lee MK, et al. Brain abscess formation in radiation necrosis of the temporal lobe following radiation therapy for nasopharyngeal carcinoma. Acta Neurochir. 2000;142(4):435–40. discussion 40-1.

    Article  CAS  PubMed  Google Scholar 

  194. Levin VA, Bidaut L, Hou P, Kumar AJ, Wefel JS, Bekele BN, et al. Randomized double-blind placebo-controlled trial of bevacizumab therapy for radiation necrosis of the central nervous system. Int J Radiat Oncol Biol Phys. 2011;79(5):1487–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  195. Tye K, Engelhard HH, Slavin KV, Nicholas MK, Chmura SJ, Kwok Y, et al. An analysis of radiation necrosis of the central nervous system treated with bevacizumab. J Neurooncol. 2014;117(2):321–7.

    Article  CAS  PubMed  Google Scholar 

  196. Ku PK, Yuen EH, Cheung DM, Chan BY, Ahuja A, Leung SF, et al. Early swallowing problems in a cohort of patients with nasopharyngeal carcinoma: Symptomatology and videofluoroscopic findings. Laryngoscope. 2007;117(1):142–6.

    Article  PubMed  Google Scholar 

  197. Ku PK, Vlantis AC, Leung SF, Lee KY, Cheung DM, Abdullah VJ, et al. Laryngopharyngeal sensory deficits and impaired pharyngeal motor function predict aspiration in patients irradiated for nasopharyngeal carcinoma. Laryngoscope. 2010;120(2):223–8.

    PubMed  Google Scholar 

  198. Ng LK, Lee KY, Chiu SN, Ku PK, van Hasselt CA, Tong MC. Silent aspiration and swallowing physiology after radiotherapy in patients with nasopharyngeal carcinoma. Head Neck. 2011;33(9):1335–9.

    Article  PubMed  Google Scholar 

  199. Tong MC, Lee KY, Yuen MT, Lo PS. Perceptions and experiences of post-irradiation swallowing difficulties in nasopharyngeal cancer survivors. Eur J Cancer Care. 2011;20(2):170–8.

    Article  CAS  Google Scholar 

  200. Yen TT, Lin CH, Jiang RS, Shih YT, Yen HR, Liang KL. Incidence of late-onset pneumonia in patients after treatment with radiotherapy for nasopharyngeal carcinoma: a nationwide population-based study. Head Neck. 2014. doi:10.1002/hed.23827.

    Google Scholar 

  201. Fua TF, Corry J, Milner AD, Cramb J, Walsham SF, Peters LJ. Intensity-modulated radiotherapy for nasopharyngeal carcinoma: clinical correlation of dose to the pharyngo-esophageal axis and dysphagia. Int J Radiat Oncol Biol Phys. 2007;67(4):976–81.

    Article  PubMed  Google Scholar 

  202. Luk YS, Shum JS, Sze HC, Chan LL, Ng WT, Lee AW. Predictive factors and radiological features of radiation-induced cranial nerve palsy in patients with nasopharyngeal carcinoma following radical radiotherapy. Oral Oncol. 2013;49(1):49–54.

    Article  PubMed  Google Scholar 

  203. Lin YS, Jen YM, Lin JC. Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma. Cancer. 2002;95(2):404–9.

    Article  PubMed  Google Scholar 

  204. Hsiung CY, Huang EY, Ting HM, Huang HY. Intensity-modulated radiotherapy for nasopharyngeal carcinoma: the reduction of radiation-induced trismus. Br J Radiol. 2008;81(970):809–14.

    Article  PubMed  Google Scholar 

  205. Chen YY, Zhao C, Wang J, Ma HL, Lai SZ, Liu Y, et al. Intensity-modulated radiation therapy reduces radiation-induced trismus in patients with nasopharyngeal carcinoma: a prospective study with >5 years of follow-up. Cancer. 2011;117(13):2910–6.

    Article  PubMed  Google Scholar 

  206. Chen KC, Yen TT, Hsieh YL, Chen HC, Jiang RS, Chen WH, et al. Postirradiated carotid blowout syndrome in patients with nasopharyngeal carcinoma: a case-control study. Head Neck. 2014.

    Google Scholar 

  207. McDonald MW, Moore MG, Johnstone PA. Risk of carotid blowout after reirradiation of the head and neck: a systematic review. Int J Radiat Oncol Biol Phys. 2012;82(3):1083–9.

    Article  PubMed  Google Scholar 

  208. Lam JW, Chan JY, Lui WM, Ho WK, Lee R, Tsang RK. Management of pseudoaneurysms of the internal carotid artery in postirradiated nasopharyngeal carcinoma patients. Laryngoscope. 2014;124(10):2292–6.

    Article  PubMed  Google Scholar 

  209. He CC, Si YF, Xie YA, Yu L. Management of intractable epistaxis in patients who received radiation therapy for nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol. 2013;270(10):2763–7.

    Article  PubMed  PubMed Central  Google Scholar 

  210. Little M, Schipper M, Feng FY, Vineberg K, Cornwall C, Murdoch-Kinch CA, et al. Reducing xerostomia after chemo-IMRT for head-and-neck cancer: beyond sparing the parotid glands. Int J Radiat Oncol Biol Phys. 2012;83(3):1007–14.

    Article  PubMed  Google Scholar 

  211. Chen JZ, Le QT, Han F, Lu LX, Huang SM, Lin CG, et al. Results of a phase 2 study examining the effects of omitting elective neck irradiation to nodal levels IV and Vb in patients with N(0–1) nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2013;85(4):929–34.

    Article  PubMed  Google Scholar 

  212. Chen J, Ou D, He X, Hu C. Sparing level Ib lymph nodes by intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma. Int J Clin Oncol. 2014;19(6):998–1004.

    Article  CAS  PubMed  Google Scholar 

  213. Cannon DM, Lee NY. Recurrence in region of spared parotid gland after definitive intensity-modulated radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2008;70(3):660–5.

    Article  PubMed  Google Scholar 

  214. Lee AW, Poon YF, Foo W, Law SC, Cheung FK, Chan DK, et al. Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976–1985: overall survival and patterns of failure. Int J Radiat Oncol Biol Phys. 1992;23(2):261–70.

    Article  CAS  PubMed  Google Scholar 

  215. Lee AW, Ng WT, Chan YH, Sze H, Chan C, Lam TH. The battle against nasopharyngeal cancer. Radiother Oncol. 2012;104(3):272–8.

    Article  PubMed  Google Scholar 

  216. Xiao WW, Huang SM, Han F, Wu SX, Lu LX, Lin CG, et al. Local control, survival, and late toxicities of locally advanced nasopharyngeal carcinoma treated by simultaneous modulated accelerated radiotherapy combined with cisplatin concurrent chemotherapy: long-term results of a phase 2 study. Cancer. 2011;117(9):1874–83.

    Article  CAS  PubMed  Google Scholar 

  217. Lai SZ, Li WF, Chen L, Luo W, Chen YY, Liu LZ, et al. How does intensity-modulated radiotherapy versus conventional two-dimensional radiotherapy influence the treatment results in nasopharyngeal carcinoma patients? Int J Radiat Oncol Biol Phys. 2011;80(3):661–8.

    Article  PubMed  Google Scholar 

  218. Lin S, Pan J, Han L, Guo Q, Hu C, Zong J, et al. Update report of nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy and hypothesis of the optimal margin. Radiother Oncol. 2014;110(3):385–9.

    Article  PubMed  Google Scholar 

  219. Wu F, Wang R, Lu H, Wei B, Feng G, Li G, et al. Concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: treatment outcomes of a prospective, multicentric clinical study. Radiother Oncol. 2014;112(1):106–11.

    Article  PubMed  Google Scholar 

  220. Huang PY, Cao KJ, Guo X, Mo HY, Guo L, Xiang YQ, et al. A randomized trial of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy for locoregionally advanced nasopharyngeal carcinoma. Oral Oncol. 2012;48(10):1038–44.

    Article  CAS  PubMed  Google Scholar 

  221. Low JS, Chua ET, Gao F, Wee JT. Stereotactic radiosurgery plus intracavitary irradiation in the salvage of nasopharyngeal carcinoma. Head Neck. 2006;28(4):321–9.

    Article  PubMed  Google Scholar 

  222. Chua DT, Sham JS, Kwong DL, Wei WI, Au GK, Choy D. Locally recurrent nasopharyngeal carcinoma: treatment results for patients with computed tomography assessment. Int J Radiat Oncol Biol Phys. 1998;41(2):379–86.

    Article  CAS  PubMed  Google Scholar 

  223. Teo PM, Kwan WH, Chan AT, Lee WY, King WW, Mok CO. 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. 1998;40(4):897–913.

    Article  CAS  PubMed  Google Scholar 

  224. Oksuz DC, Meral G, Uzel O, Cagatay P, Turkan S. Reirradiation for locally recurrent nasopharyngeal carcinoma: treatment results and prognostic factors. Int J Radiat Oncol Biol Phys. 2004;60(2):388–94.

    Article  PubMed  Google Scholar 

  225. Zheng XK, Ma J, Chen LH, Xia YF, Shi YS. Dosimetric and clinical results of three-dimensional conformal radiotherapy for locally recurrent nasopharyngeal carcinoma. Radiother Oncol. 2005;75(2):197–203.

    Article  PubMed  Google Scholar 

  226. Chua DT, Sham JS, Leung LH, Au GK. Re-irradiation of nasopharyngeal carcinoma with intensity-modulated radiotherapy. Radiother Oncol. 2005;77(3):290–4.

    Article  PubMed  Google Scholar 

  227. Qiu S, Lin S, Tham IW, Pan J, Lu J, Lu JJ. Intensity-modulated radiation therapy in the salvage of locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2012;83(2):676–83.

    Article  PubMed  Google Scholar 

  228. Huang HQ, Cai QQ, Lin XB, Wang AL, Bu Q, Hu XH, et al. Preliminary result of multi-center clinical trial on the docetaxel, 5-Fu and DDP in the treatment of advanced, recurrent or metastatic nasopharyngeal carcinoma. Zhonghua zhong liu za zhi [Chinese J Oncol]. 2008;30(4):314–6.

    Google Scholar 

  229. Yeo W, Leung TW, Chan AT, Chiu SK, Yu P, Mok TS, et al. A phase II study of combination paclitaxel and carboplatin in advanced nasopharyngeal carcinoma. Eur J Cancer. 1998;34(13):2027–31.

    Article  CAS  PubMed  Google Scholar 

  230. Tan EH, Khoo KS, Wee J, Fong KW, Lee KS, Lee KM, et al. Phase II trial of a paclitaxel and carboplatin combination in Asian patients with metastatic nasopharyngeal carcinoma. Ann Oncol. 1999;10(2):235–7.

    Article  CAS  PubMed  Google Scholar 

  231. Ma BB, Hui EP, Wong SC, Tung SY, Yuen KK, King A, et al. Multicenter phase II study of gemcitabine and oxaliplatin in advanced nasopharyngeal carcinoma—correlation with excision repair cross-complementing-1 polymorphisms. Ann Oncol. 2009;20(11):1854–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China

    Wai Tong Ng MD, FRCR & Siu Hong Chan FRCR

  2. Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China

    Roger K. C. Ngan FRCR

  3. Department of Clinical Oncology, Queen Mary Hospital, Li Ka Shing, The University of Hong Kong, Hong Kong, China

    Henry Sze MBBS, FRCR, FHKCR, FHKAM, PDip

  4. Department of Surgery, Queen Mary Hospital, Hong Kong, China

    Jimmy Y. W. Chan MS

  5. Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan First Road, Futian District, Shenzhen, Guangdong Province, 518053, China

    Anne W. M. Lee MD, FRCR

Authors
  1. Wai Tong Ng MD, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roger K. C. Ngan FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Siu Hong Chan FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Henry Sze MBBS, FRCR, FHKCR, FHKAM, PDip
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jimmy Y. W. Chan MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anne W. M. Lee MD, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne W. M. Lee MD, FRCR .

Editor information

Editors and Affiliations

  1. Department of Radio-Oncology, Genolier Swiss Medical Network, Genolier, Switzerland

    Jacques Bernier

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Ng, W.T., Ngan, R.K.C., Chan, S.H., Sze, H., Chan, J.Y.W., Lee, A.W.M. (2016). Management of Nasopharyngeal Carcinoma. In: Bernier, J. (eds) Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-27601-4_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27601-4_26

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27599-4

  • Online ISBN: 978-3-319-27601-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation