Similar to other head and neck cancers, successful delivery of radiation therapy (RT) in nasopharyngeal cancer (NPC) is challenging. Reasons include technical aspects, such as treatment planning (especially in the era of intensity-modulated RT and simultaneous integrated boosting), physician experience in target delineation (eg, knowing routes of subclinical nodal spread), available technologies (eg, image-guided RT), coordination of multimodality therapy, and treatment of acute and late toxic effects.
Vivek Verma, Pamela K. Allen, Charles B. Simone, Hiram A. Gay, Steven H. Lin. Association of Treatment at High-Volume Facilities With Survival in Patients Receiving Chemoradiotherapy for Nasopharyngeal Cancer. JAMA Otolaryngol Head Neck Surg. Published online November 02, 2017. doi:10.1001/jamaoto.2017.1874