How far have we achieved by systemic therapy for recurrent/metastatic nasopharyngeal carcinoma?

Nasopharyngeal carcinoma of undifferentiated type is distinctive in terms of radical and geographical distribution, with highest incidence in Southern China, Taiwan and Singapore, followed by North Africa and Alaska. Radiotherapy with contemporary techniques like intensity-modulated radiation therapy is the mainstay of treatment for early-stage disease, while concurrent chemoradiation with or without adjunct chemotherapy is indicated in locoregionally advanced disease (1). Nevertheless, about 30% of patients develop recurrence or metastasis despite intensive radical treatment (2). Though most of these relapsed patients have an unfavorable survival outcome, their survival can be significantly prolonged with palliative chemotherapy.