{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:33:02Z","timestamp":1789781582746,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Salvage treatment of locoregionally recurrent nasopharyngeal carcinoma (NPC) requires weighing the benefits of re\u2010irradiation against increased risks of toxicity. Here, we evaluated the outcomes of patients treated with intensity\u2010modulated\u2010based pulsed low\u2010dose\u2010rate radiotherapy (PLDR\u2010IMRT) to enhance the curative effect of salvage treatment and reduce RT\u2010related SAEs. A prospective clinical trial was conducted from March 2018 to March 2020 at multiple institutions. NPC patients who experienced relapse after radical therapy were re\u2010irradiated with a median dose of 60\u2009Gy (50.4\u201370\u2009Gy)\/30 f (28\u201335 f) using PLDR\u2010IMRT. Thirty\u2010six NPC patients who underwent PLDR\u2010IMRT for locoregional recurrence were identified. With a median follow\u2010up of 26.2\u00a0months, the objective response rate (ORR) of the entire cohort was 91.6%. The estimated mPFS duration was 28\u2009months (95% CI: 24.9\u201331.1), and the estimated mLRFS duration was 30.4\u00a0months (95% CI: 25.2\u201335.5). The overall survival (OS) rate for all patients was 80.6%, the progression\u2010free survival (PFS) rate was 75% and the cancer\u2010specific survival (CSS) rate was 88.9% at 1\u00a0year. The LRFS and DMFS rates were 88.9% and 91.7%, respectively, at 1\u00a0year. A combination of systematic therapies could provide survival benefits to patients who experience NPC relapse (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05), and a Karnofsky performance status (KPS) score of \u226590 was a favorable factor for local control (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05). The incidence of acute SAEs (grade 3+) from PLDR was 22.2%, and the incidence of chronic SAEs was 19.4% among all patients. PLDR\u2010IMRT combined with systematic therapy can effectively treat patients with locoregionally recurrent nasopharyngeal carcinoma and causes fewer adverse events than the rates expected with IMRT.<\/jats:p>","DOI":"10.1111\/cas.15759","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T06:41:52Z","timestamp":1676443312000},"page":"2534-2543","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy and safety of <scp>PLDR\u2010IMRT<\/scp> for the re\u2010irradiation of recurrent <scp>NPC<\/scp>: A prospective, single\u2010arm, multicenter trial"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2649-6134","authenticated-orcid":false,"given":"Rui","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Li","sequence":"additional","affiliation":[{"name":"The General Hospital of Western Theater Command  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology Xinqiao Hospital, Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology MianYang Central Hospital  Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhui","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Sun Yat\u2010sen Memorial Hospital, Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Churong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; 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