Long-term patterns of relapse and survival following definitive intensity-modulated radiotherapy for non-endemic nasopharyngeal carcinoma.
BACKGROUND
We report treatment outcomes for a large non-endemic cohort of patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT) and chemotherapy.


METHODS
We identified 177 consecutive patients with newly diagnosed, non-metastatic nasopharyngeal cancer treated with definitive IMRT between 1998 and 2011. Endpoints included local, regional, distant control, and overall survival.


RESULTS
Median follow-up was 52months. The 3-/5-year actuarial rates of local control, regional control, distant control, and overall survival were 92%/83%, 93%/91%, 86%/83%, and 87%/74%, respectively. The median time to local recurrence was 30months; the annual hazard of local recurrence did not diminish until the 6th year of follow-up.


CONCLUSIONS
Overall, we observed excellent rates of disease control and survival consistent with initially reported results from our institution. Attaining locoregional control in patients with extensive primary tumors remains a significant clinical challenge. With mature follow-up we observed that more than half of observed local relapses occurred after 2years, a pattern distinct from that of carcinomas arising from other head and neck sites. These findings raise the possibility that patients with NPC may benefit from close follow-up during post-treatment years 3-5.
['Setton|Jeremy|J|', 'Han|James|J|', 'Kannarunimit|Danita|D|', 'Wuu|Yen-Ruh|YR|', 'Rosenberg|Stephen A|SA|', 'DeSelm|Carl|C|', 'Wolden|Suzanne L|SL|', 'Jillian Tsai|C|C|', 'McBride|Sean M|SM|', 'Riaz|Nadeem|N|', 'Lee|Nancy Y|NY|']
D000328:Adult D000368:Aged D002277:Carcinoma D003131:Combined Modality Therapy D018572:Disease-Free Survival D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D000077274:Nasopharyngeal Carcinoma D009303:Nasopharyngeal Neoplasms D009364:Neoplasm Recurrence, Local D050397:Radiotherapy, Intensity-Modulated D012189:Retrospective Studies D016896:Treatment Outcome
Radiotherapy Nasopharyngeal carcinoma IMRT Clinical outcomes