Stratification 1	Stratification 2	Grade I recommendations	Grade II recommendations	Grade III recommendations
Suitable for surgery	Local recurrence of nasopharynx	Surgery [174, 175, 176, 177, 178, 179, 180, 181, 182, 183] (evidence 1A)	Re‐radiotherapy [174, 175, 176, 177, 178] (evidence 2A) Chemotherapy/ immunotherapy/ targeted therapy† (evidence 2A)
	Neck recurrence	Surgery [174, 175, 184] (evidence 2A)	Radiotherapy [174, 175, 178] (evidence 2A)
Unsuitable for surgery	Suitable for radiotherapy	Radiotherapy with or without chemotherapy† [4, 177, 178, 185] (evidence 2A)	Chemotherapy/ immunotherapy/ targeted therapy† (evidence 2A)
	Unsuitable for radiotherapy	Chemotherapy/ immunotherapy/ targeted therapy† (evidence 2A)

^*This recommendation is based on published papers only.

^†Refers to chemotherapy/immunotherapy/targeted therapy for metastatic NPC.

Definition of patients unsuitable for surgery: The patient's physical condition does not allow it, the surgery is refused for various reasons, or the tumor burden is too large to be removed.

Definition of patients unsuitable for radiotherapy: They are not expected to benefit from radiotherapy; taking into account factors such as age, Karnofsky performance status (KPS), gross tumor volume (GTV), recurrence T stage; they have regional lymph node metastasis; and they have grade ≥3 adverse events in the previous radiotherapy.