{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:23:38Z","timestamp":1781144618671,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T00:00:00Z","timestamp":1468972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the sites of nodal failure (NF) of nasopharyngeal carcinoma (NPC) treated with intensity\u2010modulated radiation therapy (IMRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the records of 165 patients with nonmetastatic NPC treated with IMRT between July 1998 and April 2011 at our institution. Recurrent nodes were delineated on imaging and coregistered with the original treatment planning computed tomography. Failures were assessed as in\u2010field, out\u2010field, or marginal based on the relative volumes of the recurrent nodes covered by the original dose distribution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten patients had NF at a median follow\u2010up of 70.4 months for surviving patients. The 3\u2010 and 5\u2010year overall survival and NF rates were 88.7%, 76.0% and 5.8%, 7.7%, respectively. Six of the nodal failures were in\u2010field, of which five occurred in level II; whereas four had out\u2010field failures, all of which were in the protected parotid gland area. There were no recurrences in level 1b despite this region being protected. The cumulative 3\u2010 and 5\u2010year failure rates in the parotid gland area were 2.2% and 3.1%, respectively. Three patients with parotid failure initially had subcentimeter, nonspecific nodules in the same locations of the parotid gland as the recurrent nodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nodal failure is uncommon after IMRT in NPC. Recurrence in the parotid gland region accounts for all of the out\u2010field failures and 40% of NF in our study. Comprehensive assessment of nodules in or around the parotid gland is therefore a key aspect of treatment planning and follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 2016 127:377\u2013382, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26139","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T13:28:48Z","timestamp":1469021328000},"page":"377-382","source":"Crossref","is-referenced-by-count":19,"title":["Patterns of nodal failure after intensity modulated radiotherapy for nasopharyngeal carcinoma"],"prefix":"10.1002","volume":"127","author":[{"given":"Jin\u2010gao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan\u2010Kettering Cancer Center New York New York U.S.A."},{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital Nanchang Jiangxi 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