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Background:This study was designed to evaluate the efficacy andsafety of tailored neck dissections based on preoperative image studies and intraoperativeexploration for the management of radiotherapy-resistant nasopharyngeal carcinoma ofthe neck.Methods : The study included 32 patients who failed radiotherapy fornasopharyngeal carcinoma of the neck and underwent a total of 36 tailored neckdissections. The patients’ clinical features, histopathologic characteristics, complications,and treatment outcome were estimated and analyzed.Results:Radical neck dissectionand modified radical neck dissection were performed on 15 and 21 necks, respectively.Twenty-five necks had multiple node metastases. Thirteen necks had node metastases at2 or more levels. The overall morbidity rate was 13.9％. The 5-year overall and diseasefree survival was 47.3％ and 33.9％, respectively. The 5-year neck control rate was76.9％.Conclusion:Tailored neck dissection is efficacious and safe for the managementof radiotherapy-resistant nasopharyngeal carcinoma of the neck.