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Purpose: To update our analysis on clinical factors and dose-volume parameters associated with local control after re-irradiation with intensity-modulated Radiotherapy (IMRT) for locally recurrent nasopharyngeal carcinoma (NPC).Method and Materials: A retrospective analysis on the comprehensive clinical data collected for a total of 248 patients with locally recurred NPC who were re-irradiated between April 2004 and January 2009.The initial treatment was conventional 2D radiotherapy (RT) with prescription dose ranging from 66-76 Gy in 2Gy fractions.The re-irradiation (second treatment) was IMRT with prescription dose in the range of 60-70Gy in 2.02-2.27 Gy per fraction.The time gap between the two treatment courses ranged from 6 months to 190 months with a median gap of 27 months.The disease re-staging was 3.5%, 11.3%,49.4% and 35.8% for stage Ⅰ, Ⅱ , Ⅲ and Ⅳ, respectively.Cisplatin-based chemotherapy was administered to 158 patients (63.7%) in addition to the IMRT re-irradiation.For this local control analysis, each tumor was analyzed separately, and its remission status was determined in a serial of follow-up MRI scans.Results: The overall local control rates were 92.3%, 86.4% and 79.5% in 1, 2 and 5 years,respectively.Multivariate analysis revealed the gap as a significant and independent prognostic factor for local control probability (p=0.034).These patients were grouped into 3 subgroups based on the gap values (A=gap>59 months, B=24.5
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