BACKGROUND: To review the outcome and evaluate the prognostic factors in the treatment of @entity177 of @entity189 ( @entity189 ). METHODS: We reviewed the records of 43 @entity1 with @entity177 of @entity189 who received salvage treatment or chemotherapy between November 1986 and January 2001. The recurrent disease was stage II in 61%, stage III in 30%, and stage IV in 9%. The @entity66 was rT1-2 in 67% and rT3-4 in 33%, and the regional disease was rN1 in 91% and rN2 in 9%. Persistent disease, @entity177 within 4 months of completion of primary radiotherapy, occurred in 53.5% and recurrent disease in 46.5%. Seventeen @entity1 received surgery for regional and/or local failures with or without combined radiotherapy (ST group), 14 @entity1 received reirradiation to both local and regional disease ( @entity138 group), and 12 @entity1 received palliative chemotherapy only (CT group). The median follow-up was 18 months (range, 4-153) and for the surviving @entity1 it was 29 months (range, 6-153). RESULTS: The 3-year relapse-free survival (RFS) rate and disease-specific survival (DSS) rate after salvage treatment or chemotherapy were 17% and 38%, respectively. The 3-year RFS rates in stage II, III, and IV disease were 25%, 8%, and 0%, respectively. The corresponding 3-year DSS rates were 43%, 28%, and 38%. The 3-year RFS rates in the ST, @entity138 , and CT group were 39%, 7%, and 0%, respectively. The corresponding 3-year DSS rates were 55%, 25%, and 25%. @entity1 whose @entity66 was treated by surgical resection had a 3-year local control rate of 71% compared with 38% by reirradiation using brachytherapy or external radiotherapy. For regional disease, the 3-year nodal control rate after radical neck dissection was 65% compared with 24% by reirradiation. Further locoregional failure represents the major failure pattern, and the proportion of @entity1 who had further local, regional, and both @entity177 were 16%, 9%, and 53%, respectively. Distant @entity3 occurred in 30% of @entity1 , and only 5% had isolated distant @entity3 in the absence of @entity177 . On multivariate analysis, treatment by reirradiation or chemotherapy alone and rN2 disease were independent factors that predicted poor survival, whereas treatment by reirradiation or chemotherapy alone was the only independent factor that predicted further relapse or failure. CONCLUSIONS: Proper selection of @entity1 for aggressive salvage treatment and individualization of treatment are important in managing @entity1 with @entity177 of @entity189 . A significant proportion of @entity1 with early stage @entity177 can still achieve long-term disease control and survival after aggressive salvage treatment using surgery with or without combined radiotherapy. In @entity1 with more @entity1442 , treatment by reirradiation alone or palliative chemotherapy is largely ineffective and is associated with a poor outcome.

Treatment outcome for XXXX of @entity189 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['local disease'] @entity138 :: ('MESH:C563738', 'Disease') :: ['RT'] @entity189 :: ('MESH:D002277', 'Disease') :: ['nasopharyngeal carcinoma', 'NPC'] @entity177 :: ('MESH:D051437', 'Disease') :: ['defined as failures', 'synchronous locoregional failures', 'locoregional failures'] @entity1442 :: ('MESH:D020178', 'Disease') :: ['advanced disease'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis']
@entity177 :: (MESH:D051437,Disease) :: ['synchronous locoregional failures']
