How would you manage the primary site of a metastatic nasopharyngeal cancer showing cCR after systemic therapy?

Would you add radiation, if so any concurrent systemic therapy?

Would you consider hypofractionation, if so, what dose/fx and reference for constraints?

Answer from: Radiation Oncologist at Academic Institution

Small phase III randomized trial of metastatic nasopharyngeal cancer patients with a CR/PR by imaging after 3 cycles of cisplatin/5FU showed that RT+chemo (primary/nodes + elective nodes) had an overall survival advantage compared with chemotherapy alone (You et al., PMID 32701129).

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Radiation Oncologist at Baylor College of Medicine
There is a phase II trial from Hong Kong as well s...

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How would you manage the primary site of a metastatic nasopharyngeal cancer showing cCR after systemic therapy?

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