Phase 3 trial of medial retropharyngeal nodal region sparing radiotherapy versus standard radiotherapy for nasopharyngeal carcinoma

Standard radiotherapy (RT) for nasopharyngeal carcinoma (NPC) encompasses both medial retropharyngeal lymph nodes (MRLN) region and lateral RLN region. A phase 3 trial at three centers in China compared MRLN region sparing RT versus standard RT for non-metastatic NPC. Three years after randomization there were no significant differences between the groups in terms of efficacy. The MRLN region sparing RT group had lower incidences of acute dysphagia and late dysphagia, and better patient reported outcomes for global health status, role functioning, social functioning, fatigue, and swallowing. The authors conclude that MRLN sparing radiotherapy showed non-inferiority in risk of local relapse, with fewer radiation related toxicity and improved patient reported outcomes.