Nasopharynx

Radiation therapy is the primary treatment for nasopharyngeal carcinoma given its difficult anatomical location for surgical resection and the knowledge of it being a radiosensitive tumor that demonstrates a dose-response to radiation. Traditionally, more advanced tumors have a significant local failure rate, in part because the dose of radiation that can be delivered is limited by critical adjacent normal structures. Various methods including brachytherapy and SBRT allow for dose escalation while also minimizing dose to the surrounding normal tissue, with SBRT also providing the benefit of being noninvasive. This chapter summarizes the use of hypofractionated RT, focusing on SBRT, for nasopharyngeal carcinoma in the definitive setting where it is used as a boost to traditional EBRT, as well as in the re-irradiation setting. Brachytherapy for H&N cancers is covered in a separate chapter.