Management of recurrent nasopharyngeal carcinoma: current perspectives

F Perri,1 G Della Vittoria Scarpati,2 F Caponigro,1 F Ionna,3 F Longo,3 S Buonopane,4 P Muto,4 M Di Marzo,5 S Pisconti,6 R Solla7 1Head and Neck/Sarcoma Medical Oncology Unit, INT IRCCS G Pascale, Naples, Italy; 2Medical Oncology Unit, ASL NA3, Hospital of Pollena Trocchia, Naples, Italy; 3Department of Otolaryngology and Head and Neck Surgery, INT IRCCS G Pascale, Naples, Italy; 4Department of Radiation Therapy, INT IRCCS G Pascale, Naples, Italy; 5Department of Abdominal Surgery, INT IRCCS G Pascale, Naples, Italy; 6Medical Oncology Unit, POC SS Annunziata, Taranto, Italy; 7Italian National Research Council, Institute of Biostructure and Bioimaging, Naples, Italy Abstract: Nasopharyngeal carcinoma is a rare disease in Western countries. Nevertheless, its incidence in China, Singapore, and other Eastern countries reaches 20 cases per 100,000 people. Being an extremely chemo- and radiosensitive disease, upfront treatment often consists in the association of intensity-modulated radiation therapy and concurrent cisplatin. Unfortunately, about 20% of the patients suffer from a radioresistant disease which recurs after upfront therapy. For these patients, mainly available therapeutic options consist in systemic therapy, in particular poly-chemotherapy. In those showing a single locoregional recurrence, chemotherapy is not considered to be the preferred approach and other different strategies may be employed. Re-irradiation and surgery are strategies that are always used more often, albeit related to high risk of morbidity. Immunotherapy and targeted therapy, such as heavy ions-based re-irradiations, are experimental but very intriguing options. Keywords: nasopharyngeal carcinoma, re-irradiation, poly-chemotherapy, radioresistant, immunotherapy &nbsp