• Yiat Horng Leong, Yu Yang Soon, Khai Mun Lee, Lea Choung Wong, Tham Ivan Weng Keong IWK Department of Radiation Oncology, National University Cancer Institute - Singapore (NCIS), Singapore., and Francis Cho Hao Ho.
• Department of Radiation Oncology, National University Cancer Institute - Singapore (NCIS), Singapore.
• Head Neck. 2018 Mar 1; 40 (3): 622-631.

BackgroundThe purpose of this clinical review was to summate the published data for the long-term outcomes of reirradiation with intensity-modulated radiotherapy (IMRT) for locally recurrent nasopharyngeal carcinoma (NPC).MethodsWe searched biomedical literature databases for eligible studies published from January 2005 to September 2016. Outcomes of interests were 5-year local failure-free survival, distant failure-free survival, overall survival (OS), and toxicities. Meta-analysis was performed using a random effects model.ResultsWe found 4 comparative and 8 noncomparative studies (n = 1768). Reirradiation was associated with pooled event rates of 72% (95% confidence interval [CI] 66%-78%; I2  = 84%), 85% (95% CI 82%-88%; I2  = 69%), and 41% (95% CI 36%-47%; I2  = 80%) for 5-year local failure-free survival, distant failure-free survival, and OS, respectively, with significant heterogeneity among the study results. The pooled event rate for grade 5 toxicities was 33% (95% CI 30%-35%; I2  = 0%) with minimal heterogeneity.ConclusionReirradiation with IMRT for locally recurrent NPC could confer long-term disease control and survival but is associated with significant mortality.© 2017 Wiley Periodicals, Inc.

23 keywords...

hide…