{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T13:49:23Z","timestamp":1781531363820,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T00:00:00Z","timestamp":1657670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2017A030312003"],"award-info":[{"award-number":["2017A030312003"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81930072"],"award-info":[{"award-number":["81930072"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We analyzed the patterns of lymph node (LN) failure and prognosis in patients with regional recurrent nasopharyngeal carcinoma (rNPC) alone after primary intensity\u2010modulated radiotherapy (IMRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 175 patients who were treated with IMRT between 2010 and 2015 and who experienced regional recurrence alone were included. Recurrent LNs were re\u2010located in the initial pretreatment imaging and IMRT plan and failures were classified as in\u2010field or out\u2010field based on target volume delineation. All patients underwent curative salvage treatment. Independent prognostic factors for overall survival (OS) were selected by multivariate Cox analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Level IIb (49.1%, 86\/175) was the most frequent recurrence site, followed by level IIa (36%), level III (18.9%), level IVa (12%), the retropharyngeal region (8%), level Va (6.9%), and the parotid region (6.9%). A total of 264 recurrent LNs were recorded: 149 (56.4%) were classified as in\u2010field failure with a prescribed dose \u226566\u2009Gy, 60 (22.7%) with 60 to &lt;66\u2009Gy, 32 (12.1%) with 50 to &lt;60\u2009Gy, and 23 (8.7%) as an out\u2010field failure, which mainly occurred in the parotid region and level Ib. After a median follow\u2010up of 52.8\u00a0months, the estimated 5\u2010year OS rate was 66.9%. Multivariate analysis showed that age, plasma Epstein\u2013Barr virus DNA level, extranodal extension, lower neck involvement, and parotid LN recurrence were independent prognostic factors of OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In\u2010field failure represented the main pattern of regional recurrence and out\u2010field failure mainly occurred in the parotid gland and level Ib. Patients with regional rNPC alone had a good prognosis after salvage treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5020","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T11:18:35Z","timestamp":1657711115000},"page":"1399-1408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Patterns and prognosis of regional recurrence in nasopharyngeal carcinoma after intensity\u2010modulated radiotherapy"],"prefix":"10.1002","volume":"12","author":[{"given":"Xiao\u2010Tang","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine Guangzhou Guangdong People's Republic of 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