Local Recurrence of Cavum Cancer: Experience of the Radiotherapy Department of the University Hospital of Marrakech

Abstract

Local recurrence of cavum cancer has a poor prognosis and poses a management problem. Re-irradiation remains the only effective therapeutic option to ensure a good local control rate, but it is limited by the doses previously received by the organs at risk in series. We retrospectively studied 8 patients re-irradiated for isolated local relapse of nasopharyngeal carcinoma, collected in the onco-hematology hospital of Marrakech between 2012 and 2022. The mean time to local relapse was 48 months (range: 10 months-12 years). The diagnosis was confirmed by biopsy in five cases and was based on MRI radiological evidence in three cases. Recurrence was classified rT1N0M0 in two cases, rT2N0M0 in three cases, rT3N0M0 in one case, and rT4N0M0 in two cases. Three patients first received chemotherapy combining taxotere, cisplatin, and 5-fluorouracil (TPF), followed by radiotherapy. Five patients received chemoradiotherapy, one of whom also received first-line chemotherapy. In our series we obtained a satisfactory rate of complete remission but at the cost of significant toxicity. Local therapeutic failures in the cavum constitute an unfavorable event. Salvage treatment involves radiotherapy associated in some cases with chemotherapy.