What to do if nasopharyngeal carcinoma recurs

In daily outpatient clinics, we often encounter patients with recurrence of nasopharyngeal carcinoma. Due to repeated radiotherapy, the bilateral masseter muscles and salivary glands have become fibrotic or atrophied, resulting in difficulty opening the mouth, severe dry mouth, eating and speaking disorders. Some even have stubborn secretory otitis media, repeated ear stuffiness, pus discharge from the middle ear, and a significant decrease in hearing. All of these have seriously affected their quality of life. Some patients even gradually develop cachexia, gradually lose weight, and finally die from reasons other than nasopharyngeal carcinoma itself, such as malnutrition.

When it reaches this stage, there is no special way to reverse it. Little do people know that for nasopharyngeal carcinoma, a malignant tumor of the head and neck that is highly prevalent in our southern provinces, although its initial treatment is mainly radiotherapy, for those residual tumors after radiotherapy, or those tumors that are controlled after radiotherapy but recur, radiotherapy or chemotherapy are not very sensitive. However, if salvage surgery is adopted, such as endoscopic skull base minimally invasive surgery and other methods for treatment, the quality of life after surgical treatment is much higher than that of repeated radiotherapy, and the survival time is also better than the treatment methods of repeated radiotherapy and chemotherapy. Zhou Jianbo, Department of Otolaryngology, Hunan Provincial People's Hospital

Endoscopic minimally invasive surgery for recurrent or residual nasopharyngeal carcinoma is a salvage surgery for patients without metastasis to the neck or other parts of the body. For example, endoscopic minimally invasive surgery utilizes the natural passages of the human nasal cavity to reach the nasopharynx under the guidance of special endoscopic surgical equipment, and removes the recurrent or residual lesions in the nasopharynx while ensuring a sufficient safety margin. Postoperatively, small doses of radiotherapy can be supplemented preventively, thus avoiding to the greatest extent the side effects of repeated radiotherapy on the head and neck, such as neck stiffness, masseter muscle rigidity, difficulty opening the mouth to eat, salivary gland fibrosis, stubborn dry mouth, and stubborn secretory otitis media, significantly improving the quality of life of patients.

It is recommended that nasopharyngeal carcinoma patients adhere to regular check-ups after the first radiotherapy treatment. For early recurrence or residual disease after radiotherapy, try to choose active treatment methods to achieve the treatment goal.