International Recommendations on Postoperative Management for Potentially Resectable Locally Recurrent Nasopharyngeal Carcinoma - Institut Gustave Roussy
Journal Articles International Journal of Radiation Oncology, Biology, Physics Year : 2024

International Recommendations on Postoperative Management for Potentially Resectable Locally Recurrent Nasopharyngeal Carcinoma

1 HKU - The University of Hong Kong
2 Shenzhen University General Hospital [China]
3 U1018 (Équipe 2) - Oncostat
4 CESP - Centre de recherche en épidémiologie et santé des populations
5 IGR - Institut Gustave Roussy
6 Faculty of Medicine Li Ka Shing
7 Samsung Medical Center Sungkyunkwan University School of Medicine
8 AOUC - Azienda Ospedaliero Universitaria Careggi [Firenze] = Careggi University Hospital [Florence, Italy]
9 Hôpital Foch [Suresnes]
10 H. Lee Moffitt Cancer Center and Research Institute
11 SYSUCC - Sun Yat-sen University Cancer Center
12 Duke-NUS Medical School [Singapore]
13 St Vincent's Hospital Melbourne [Australia]
14 Inserm U1312 - BRIC - BoRdeaux Institute in onCology
15 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
16 Vall d'Hebron University Hospital [Barcelona]
17 Fudan University [Shanghai]
18 Stanford University
19 MSK2C - Memorial Sloan Kettering Cancer Center [New York, NY, USA]
20 The Second Xiangya Hospital of Central South University
21 NUH - National University Hospital [Singapore]
22 Changhua Christian Hospital
23 UF - University of Florida [Gainesville]
24 CCF - Département de cancérologie cervico-faciale [Gustave Roussy]
25 PMNCO - Prédicteurs moléculaires et nouvelles cibles en oncologie
26 University of Toronto
27 Princess Margaret Hospital
28 Acibadem University
29 Fujian Medical University
30 MICURAE - Guangdong General Hospital [Guangzhou]
31 University of Texas Southwestern Medical Center [Dallas]
32 UPMC - University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis]
33 Université Paris-Saclay
34 NUS - National University of Singapore
35 UC San Francisco - University of California [San Francisco]
Quynh-Thu Le
  • Function : Author
Enis Ozyar
  • Function : Author

Abstract

Locally recurrent nasopharyngeal carcinoma (NPC) presents substantial challenges in clinical management. Although postoperative re-irradiation (re-RT) has been acknowledged as a potential treatment option, standardized guidelines and consensus regarding the use of re-RT in this context are lacking. This article provides a comprehensive review and summary of international recommendations on postoperative management for potentially resectable locally recurrent NPC, with a special focus on postoperative re-RT. A thorough search was conducted to identify relevant studies on postoperative re-RT for locally recurrent NPC. Controversial issues, including resectability criteria, margin assessment, indications for postoperative re-RT, and the optimal dose and method of re-RT, were addressed through a Delphi consensus process. The consensus recommendations emphasize the need for a clearer and broader definition of resectability, highlighting the importance of achieving clear surgical margins, preferably through an en bloc approach with frozen section margin assessment. Furthermore, these guidelines suggest considering re-RT for patients with positive or close margins. Optimal postoperative re-RT doses typically range around 60 Gy, and hyperfractionation has shown promise in reducing toxicity. These guidelines aim to assist clinicians in making evidence-based decisions and improving patient outcomes in the management of potentially resectable locally recurrent NPC. By addressing key areas of controversy and providing recommendations on resectability, margin assessment, and re-RT parameters, these guidelines serve as a valuable resource for clinical experts involved in the treatment of locally recurrent NPC.
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inserm-04707057 , version 1 (24-09-2024)

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Ji-Shi Li, Pierre Blanchard, Charlene H L Wong, Yong Chan Ahn, Pierluigi Bonomo, et al.. International Recommendations on Postoperative Management for Potentially Resectable Locally Recurrent Nasopharyngeal Carcinoma. International Journal of Radiation Oncology, Biology, Physics, 2024, S0360-3016 (24), pp.02954-02957. ⟨10.1016/j.ijrobp.2024.07.2143⟩. ⟨inserm-04707057⟩
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