Radiation therapy

High-dose radiation therapy with chemotherapy is the initial treatment of patients with nasopharyngeal carcinoma for the primary tumor site and the neck.[1] Selected patients with local recurrence may be retreated with moderate-dose external-beam radiation therapy (EBRT) using intensity-modulated radiation therapy, stereotactic radiation therapy, or intracavitary or interstitial radiation to the site of recurrence.[2-4]; [5][Level of evidence C2]; [6-9][Level of evidence C3] Radiation therapy dose and field margins are individually tailored to the location and size of the primary tumor and lymph nodes.[10-13]

Most tumors are treated with EBRT exclusively. For some patients, radiation therapy may be boosted with intracavitary or interstitial implants or by the use of stereotactic radiosurgery when clinical expertise is available and the anatomy is suitable.[2,14-17]