Will Re-irradiation Alone Prevent Loco-regional Progression in Isolated Nodal Recurrence of Nasopharyngeal Carcinoma? - A Case Report

Sasikala Prabaharan, Sasikala Prabaharan, Praveen Kumar Marimuthu, Sarath chandra Reddy, Sarath chandra Reddy, Ramesh S Bilimagga

Abstract


We report a case of 60 year old male with nasopharyngeal squamous cell carcinoma T2N3aMo treated with concurrent chemo-radiation 66Gy in 30 fractions with concurrent weekly carboplatin. On 1 year follow up, the patient had residual left level Ⅱnode, for which 6 cycles of Paclitaxel, cisplatin and 5-Fluorouracil (TPF) was given. Following one year disease free interval, the cancer recurred on same left level II region, for which left Modified Radical Neck Dissection was done. Post-operative re-irradiation 60 Gy in 30 fractions was given in view of extracapsular extension. After a disease free interval of 8 months, recurrence was found in nasopharynx and contralateral right level III nodal region. In our case, re-irradiation without chemotherapy has not improved disease free interval. Therefore, systemic chemotherapy along with re-irradiation should be considered for isolated nodal recurrence with extracapsular extension.

Keywords


recurrent nasopharyngeal carcinoma, isolated neck recurrence, reirradiation

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References


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DOI: http://dx.doi.org/10.15383/jnpc.39

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