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Table 3 Features of the three patients with recurrence at the level Ib LNs after intensity-modulated radiotherapy

From: Investigation of the feasibility of elective irradiation to neck level Ib using intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma: a retrospective analysis

   Case 1 Case 2 Case 3
Tumor involvement    
  Staging T4N3a T3N2 T4N3b
  Positive bilateral CLNs Yes Yes Yes
  DLN-IIa ≥20 mm or level IIa lymph nodes with ES None Right Right
  Oropharynx involvement Left None None
Irradiation of neck level Ib Bilateral Right Right
Recurrence at neck level Ib    
  Laterality Left Right Left
  Other regional recurrence IA + IIb + IV + Vb IIa + IIb + III Ib
  Concomitant failure Axillary LNs - Paranasophrynx+skull base
  Time to recurrence 12 months 12 months 23 months
  Salvage treatment Chemo Chemo + surgery Chemo + RT
  Treatment response PD PD PR
  Sequential failure Death due to multiple metastasis Axillary and mediastinal LNs Death due to intractable epistaxis
  1. Abbreviations: LNs, lymph nodes. D LN-IIa , greatest dimension of level IIa lymph nodes; ES, extra-capsular spread; chemo, chemotherapy; RT, radiotherapy; PD, progressive disease; PR, partial response