{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:14:49Z","timestamp":1790810089222,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"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":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study assessed long\u2010term outcomes in nasopharyngeal carcinoma (NPC) patients treated with modern intensity\u2010modulated radiation therapy (IMRT), focusing on recurrence patterns and postrecurrence survival (PRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 1554 NPC patients treated with definitive radiotherapy or concurrent chemoradiotherapy (CCRT) between 2005 and 2019 was analyzed using competing\u2010risk models. Cumulative incidences of recurrence or death, local recurrence or death, regional recurrence or death, and distant recurrence or death were calculated, with subgroup differences evaluated by Gray's test. PRS was assessed using Kaplan\u2013Meier curves, log\u2010rank tests, and Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 3\u2010, 5\u2010, and 10\u2010year cumulative incidences of recurrence or death were 0.143, 0.162, and 0.187. T4 tumors showed poorer local control, and cumulative incidences of distant recurrence or death correlated with N classification. Most recurrences occurred within 2\u20133\u2009years, with distant recurrences significantly reducing PRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IMRT provides excellent local\u2010regional control but requires improvement for T4 tumors and distant recurrences affecting PRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.28228","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T04:48:28Z","timestamp":1750999708000},"page":"3076-3085","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Nasopharyngeal Carcinoma in Intensity\u2010Modulated Radiation Therapy Era: Competing\u2010Risk Analysis, Recurrence, and Postrecurrence Survival"],"prefix":"10.1002","volume":"47","author":[{"given":"Chun\u2010Wei","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology, Department of Oncology National Taiwan University Hospital  Taipei Taiwan"},{"name":"Cancer Research Center National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Department of Radiology College of Medicine, National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing\u2010Shen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiang\u2010Kuang","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Department of Oncology National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Radiation Oncology National 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