Local and Lymph Node Relapse of Nasopharyngeal Carcinoma: A Single-Center Experience

• Published in: Ear, nose, & throat journal nose, & throat journal, 2021-09, Vol.100 (5_suppl), p.795S-800S
• Main Authors: Toumi, Nabil, Ennouri, Sana, Charfeddine, Ilhem, Daoud, Jamel, Khanfir, Afef
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemoradiotherapy; Chemotherapy; Female; Humans; Induction Chemotherapy; Lymph Nodes - pathology; Lymphatic system; Male; Medical prognosis; Middle Aged; Nasopharyngeal Carcinoma - mortality; Nasopharyngeal Carcinoma - pathology; Nasopharyngeal Carcinoma - therapy; Nasopharyngeal Neoplasms - mortality; Nasopharyngeal Neoplasms - pathology; Nasopharyngeal Neoplasms - therapy; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Neoplasm Staging; Otolaryngology; Patients; Radiation therapy; Retrospective Studies; Survival Analysis; Throat cancer; Young Adult
• ISSN: 0145-5613; 1942-7522
• DOI: 10.1177/0145561320908955

Objectives: The study aimed to investigate the epidemiological and clinical characteristics as well as the therapeutic results in patients with locoregional (LR) relapse after treatment of nasopharyngeal carcinoma (NPC). Methods: We retrospectively reviewed the medical records of patients with local and/or regional recurrent NPC over 13 years (2003-2015). Results: Twenty-five patients were treated for local or/and local–regional recurrence of NPC. The rate of LR relapse was 7.2%. The mean age of the patients was 46 ± 13.9 years. The median time to relapse was 25 months. The recurrence was nasopharyngeal in 17 patients, nasopharyngeal and neck lymph nodes in 7 patients, and neck lymph nodes in 1 patient. Fifteen relapsed patients had a locally advanced disease (rT3-rT4). Patients who had initially T1 or T2 tumor had a locally advanced relapsed disease (rT3rT4) in 27.3% and patients whose disease was initially classified as T3 or T4 had a locally advanced relapsed disease (rT3T4) in 85.7% (P = .005, Fisher test). Twelve patients had chemotherapy after relapse. Chemotherapy was followed by concurrent chemoradiotherapy in 3 patients and by radiotherapy (RT) in 4 patients. Nine patients had concurrent chemoradiotherapy and 1 patient had exclusive RT. The overall survival (OS) at 1 year, 3 years, and 5 years was, respectively, 58%, 18%, and 10%. The OS was significantly higher in patients with good performance status at the time of relapse (World Health Organization = 1; P = .01) and in patients with late relapse (after 2 years; P = .03). Conclusions: Locoregional relapse rate in our study was 7.2%. Locoregional reirradiation was the mainstay treatment modality in relapsed NPC. Relapsed NPC had a poor prognosis with a 5-year survival rate of 18%. The OS was significantly higher in patients with good performance status and in patients with late relapse (after 2 years).