Page 25 - Head and neck surgery
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In patients with advanced staged disease (stage III & IV), the addition of systemic chemotherapy
in the concurrent setting with radiotherapy was shown to significantly improve local tumour
control, overall survival and progression-free survival (Intergroup-0099 Study, Al-Sarraf 1998).
Treatment of tumour recurrence after radiotherapy has been controversial in the past. Recurrent
tumour cells may be radio-resistant, making re-irradiation potentially less effective. Furthermore,
accumulated toxicities of additional radiation lead to significant side effects that adversely affect
the quality of life.
Nowadays, surgery is the standard of treatment for recurrent NPC.
