Abstract

Materials & Methods: We reviewed the records of 74 patients with locally recurrent nasophatyngeal carcinoma treated at the University of California, San Francisco between 1957 and 1995. The histologic types included squamous cell carcinoma in 6 (8.1%), non-keratinizing carcinoma in 48 (64.9%), and undifferentiated carcinoma in 20 (27%) cases The site of recurrence was in the primary in 46 (62.2%), in the neck nodes in 20 (27%) , and in both sites in 8 (10.8%) patients. The recurrent disease was stage I in 10 (13.5%), stage II in 16 (21.6%), stage Ill in 20 (27%), and stage IV in 28 (37.9%). Thirty-seven (50%) patients developed recurrence within 2 years and 58 (78.4%) within 5 years after initial treatment. Radiotherapeutic techniques used in the re-treatment of primary recurrence consisted of external beam radiotherapy (EERT), intracavitary brachytherapy, heavy charged particle beam, gamma knife alone or in combination. Re-irradiation doses ranged from 18 to 108 Gy with a median dose of 60 Gy. Treatment of recurrent neck nodes consisted of radical neck dissection (RND) + intraoperative radiotherapy (IORT), or EBRT + hyperthermia, or chemotherapy + hyperthermia. Chemotherapy was used in 22 (30%) patients. Median follow-up was 20 months (range: 2 to 308 months).

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