{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:42:02Z","timestamp":1780393322810,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The choice between endoscopic surgery and re\u2010radiotherapy as the main treatment modality in patients with advanced recurrent nasopharyngeal carcinoma (rNPC) remains controversial. Therefore, in this study, we compared the efficacies of endoscopic surgery and intensity\u2010modulated radiotherapy (IMRT) in patients with rNPC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with advanced rNPC (T3 and T4) who underwent salvage treatment were enrolled from January 2009 to December 2020. Overall survival (OS) was analyzed using a log\u2010rank analysis. Univariate and multivariate analyses of OS were performed using a Cox regression model. Common treatment\u2010related complications of endoscopic surgery were compared with those of IMRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The numbers of patients with T3 and T4 tumors were 163 (64.2%) and 91 (35.8%), respectively; 192 patients underwent endoscopic surgery, 51 received IMRT, and 11 received three\u2010dimensional conformal radiotherapy (3D\u2010CRT). The 3\u2010year OS of patients treated with endoscopic surgery was 59.3%, which was significantly higher than that of patients treated with IMRT (34.7%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) or 3D\u2010CRT (43.6%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.012). Multivariate analyses showed that IMRT was an independent risk factor for OS compared with endoscopic surgery (hazard ratio, 2.068; 95% confidence interval, 1.395\u20133.069, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Complications of aural fullness (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001), nasopharyngeal necrosis (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004), nasopharyngeal hemorrhage (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004), dysphagia (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and cerebral infarction (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.030) were significantly lower in the endoscopic surgery group than in the IMRT group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopic surgery may be a more promising salvage treatment than IMRT to maximize survival and minimize treatment\u2010related complications in advanced rNPC. These results will be significant in deciding the optimal treatment for patients with advanced rNPC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23051","type":"journal-article","created":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T05:23:40Z","timestamp":1656134620000},"page":"140-150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Endoscopic surgery is superior to intensity\u2010modulated radiotherapy in the treatment of advanced recurrent nasopharyngeal carcinoma"],"prefix":"10.1002","volume":"13","author":[{"given":"Wanpeng","family":"Li","sequence":"first","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Zhang","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Eye and ENT Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8916-8675","authenticated-orcid":false,"given":"Haoyuan","family":"Xu","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; 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