NCT07180173

Upfront Neck Dissection Before Radiotherapy in Stage N3 Nasopharyngeal Carcinoma: A Retrospective Study

Retrospective Analysis of Upfront Neck Dissection Before Radiotherapy in Stage N3 Nasopharyngeal Carcinoma

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 7 (actual)
• Sponsor: Taichung Veterans General Hospital · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This retrospective observational study aims to evaluate the association between neck tumor burden and high-risk imaging features with locoregional recurrence and distant metastasis in patients with stage N3 nasopharyngeal carcinoma, and to explore the potential benefits of neck dissection, with or without re-irradiation or systemic therapy, in improving regional control and survival. The key questions addressed are whether high N burden and high-risk imaging features are significantly correlated with neck recurrence and distant metastasis, and whether salvage neck treatment (such as neck dissection ± re-irradiation/systemic therapy) can improve regional control and survival outcomes in this high-risk population.

Detailed description

Nasopharyngeal carcinoma (NPC), due to its anatomical proximity to the skull base and critical cervical structures, is primarily treated with radiotherapy. However, even with current standard treatments, a subset of patients still develop locoregional failure with poor outcomes. Previous data have shown that the 5-year locoregional control rate for stage IV disease is approximately 80.7%, corresponding to a failure rate of about 20%. Among these, patients with T1-4N3 disease have a lower 3-year distant failure-free survival compared with T4N0-2, indicating that high N stage is associated not only with regional recurrence but also with increased risk of distant metastasis. Based on this, we hypothesize that high nodal burden and high-risk imaging features are significantly associated with cervical recurrence and distant metastasis, and that appropriate and timely salvage treatment to the neck (such as neck dissection with or without re-irradiation/systemic therapy) may improve regional control and survival.

Conditions

• Oncology
• Radiology

Interventions

Type	Name	Description
RADIATION	Salvage Neck Treatment	Salvage neck treatment, including neck dissection with or without re-irradiation and/or systemic therapy, administered to patients with stage N3 nasopharyngeal carcinoma after completion of definitive concurrent chemoradiotherapy (CCRT) or induction chemotherapy followed by radiotherapy/CCRT.

Timeline

• Start date: 2007-04-01
• Primary completion: 2024-05-31
• Completion: 2025-12-15
• First posted: 2025-09-18
• Last updated: 2026-03-24

Locations

1 site across 1 country: Taiwan