局部复发性鼻咽癌（NPC）给临床治疗带来了巨大的挑战。虽然术后再放疗 (re-RT) 已被认为是一种潜在的治疗选择，但在这种情况下缺乏关于使用再放疗的标准化指南和共识。本文对可能可切除的局部复发性鼻咽癌术后管理的国际建议进行了全面的回顾和总结，特别关注术后再放疗。我们进行了彻底的搜索，以确定局部复发性鼻咽癌术后再放疗的相关研究。通过德尔菲共识流程解决了有争议的问题，包括可切除性标准、切缘评估、术后再放疗的指征以及再放疗的最佳剂量和方法。共识建议强调需要对可切除性有一个更清晰和更广泛的定义，强调实现清晰手术切缘的重要性，最好通过冰冻切片切缘评估的整体方法。此外，这些指南建议考虑对切缘阳性或接近的患者进行再放疗。最佳术后再放疗剂量通常在 60Gy 左右，超分割已显示出降低毒性的希望。这些指南旨在帮助临床医生在治疗可能可切除的局部复发性鼻咽癌时做出基于证据的决策并改善患者的治疗结果。通过解决关键争议领域并提供有关可切除性、切缘评估和再放疗参数的建议，这些指南为参与治疗局部复发性鼻咽癌的临床专家提供了宝贵的资源。本文提供了有关术后管理的国际建议潜在可切除的局部复发鼻咽癌（NPC），特别关注术后再放疗（re-RT）。共识指南强调了实现清晰手术切缘的重要性，建议考虑对切缘阳性或接近的患者进行再放疗，推荐最佳再放疗剂量约为 60Gy，并建议使用超分割来减少毒性。目的是改善可切除局部复发性鼻咽癌的治疗效果。版权所有 © 2024。由 Elsevier Inc. 出版。

Locally recurrent nasopharyngeal carcinoma (NPC) presents substantial challenges in clinical management. While postoperative re-irradiation (re-RT) has been acknowledged as a potential treatment option, standardized guidelines and consensus regarding the use of re-RT in this context are lacking. This article provides a comprehensive review and summary of international recommendations on postoperative management for potentially resectable locally recurrent NPC, with a special focus on postoperative re-RT.A thorough search was conducted to identify relevant studies on postoperative re-RT for locally recurrent NPC. Controversial issues, including resectability criteria, margin assessment, indications for postoperative re-RT, and the optimal dose and method of re-RT, were addressed through a Delphi consensus process.The consensus recommendations emphasize the need for a clearer and broader definition of resectability, highlighting the importance of achieving clear surgical margins, preferably through an en bloc approach with frozen section margin assessment. Furthermore, these guidelines suggest considering re-RT for patients with positive or close margins. Optimal postoperative re-RT doses typically range around 60Gy, and hyperfractionation has shown promise in reducing toxicity.These guidelines aim to assist clinicians in making evidence-based decisions and improving patient outcomes in the management of potentially resectable locally recurrent NPC. By addressing key areas of controversy and providing recommendations on resectability, margin assessment, and re-RT parameters, these guidelines serve as a valuable resource for the clinical experts involved in the treatment of locally recurrent NPC.This article provides international recommendations on postoperative management for potentially resectable locally recurrent nasopharyngeal carcinoma (NPC), with a special focus on postoperative re-irradiation (re-RT). The consensus guidelines highlight the importance of achieving clear surgical margins, suggest considering re-RT for patients with positive or close margins, recommend an optimal re-RT dose of around 60Gy, and propose the use of hyperfractionation to reduce toxicity. The aim is to improve patient outcomes in the management of resectable locally recurrent NPC.Copyright © 2024. Published by Elsevier Inc.