Nasopharyngeal carcinoma

Abstract

© Springer International Publishing Switzerland 2017. 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.