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How would you manage a local recurrence at the skull base after concurrent chemoRT for locally advanced nasopharyngeal carcinoma?

Given not surgical candidate and within 1 year of chemoRT (recurrence within RT field), would you repeat chemoRT, RT alone, or systemic therapy alone? What about if the patient is not a candidate for high dose cisplatin?
2 Answers
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Medical Oncology · Florida Cancer Specialists
Answered on

Available data does not support re-irradiation when the recurrence is less than 1 year after primary treatment.

In this case I would favor systemic therapy, either with platinum-gemcitabine or Pembrolizumab if pts tumor is PD-L1 positive.

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Mednet Member
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Medical Oncology · University of Texas MD Anderson Cancer Center
Answered on

I agree with Cesar. I would also get molecular profiling (Foundation One or similar) because there may be trials available in the future.

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