At present, comprehensive treatment based on radiation therapy is the most effective treatment for nasopharyngeal carcinoma. However, a small number of patients still have local recurrence after treatment, which becomes one of the main reasons for failure after treatment for nasopharyngeal carcinoma. For local recurrence of nasopharyngeal cancer, if it can be detected early, there is a chance to choose some high-efficiency and low-toxicity methods for treatment, so that the tumor can be controlled more effectively and the survival quality can be better. The key to early detection of nasopharyngeal cancer recurrence lies in timely review after treatment.
Local recurrence is one of the main reasons for treatment failure of nasopharyngeal cancer. If the recurrence of nasopharyngeal cancer is detected early and the size of recurring tumor is small, microwave, radio frequency, laser and surgery can be used for treatment. These treatments can cure recurrent nasopharyngeal cancer and have the advantages of short treatment time, low cost, less toxic reactions and light after-effects.
Some patients with nasopharyngeal carcinoma do not listen to the instructions of their primary care physicians or do not follow the prescribed time for review due to other reasons. These patients can only undergo the second course of radiation therapy, and some of them can only use palliative radiation therapy or chemotherapy because the tumor is too advanced. Although the second course of radiation therapy for recurrent nasopharyngeal cancer has a chance of cure (5-year survival rate of about 30%), this chance is significantly smaller than the first course of radiation therapy (5-year survival rate of about 70%). Moreover, these patients are prone to serious radiation sequelae, which significantly reduces the quality of patients’ survival.
Some patients with recurrence of nasopharyngeal cancer after treatment have not returned to the hospital for review as required. In one case, the nasopharynx recurred and the tumor destroyed the bone at the skull base and invaded the brain tissue, losing the opportunity to apply microwave and other treatments. Although this patient received the second course of radiation therapy (intensity-modulated radiation therapy), the recent efficacy was not satisfactory. Another case was a recurrence of lymph nodes in the neck, and the tumor invaded the skin and formed a cancerous ulcer. This patient could only receive palliative treatment, and the outcome was predictable. There were also 2 patients with nasopharyngeal recurrence in which the tumor invaded the large blood vessels in the parapharyngeal space. Both patients died due to failure of resuscitation for nasopharyngeal hemorrhage.
The majority of patients with nasopharyngeal cancer recurred within 5 years after treatment, and the number of recurrences within 3 years after treatment accounted for about 65% of all cases. Although there are not many patients with recurrence within 1 year after treatment, the cancer cells of these patients are resistant to radiation therapy. If these patients apply radiation therapy again, the treatment effect is very poor. Moreover, due to the short interval between two radiotherapy treatments, the incidence of radiation sequelae is obviously increased, and the severity of sequelae is obviously increased, which greatly reduces the survival quality of patients. Therefore, the review in the first year after treatment should be given enough attention.
When should I return to the hospital for review after nasopharyngeal cancer radiotherapy? According to the requirements of nasopharyngeal cancer diagnosis and treatment standard, nasopharyngeal cancer should be reviewed every three months in the first three years after treatment; every six months in the fourth and fifth years after treatment; and once a year after five years of treatment. In case of abnormalities, one should return to the hospital immediately for examination.