The purposes of this study are to evaluate prognosis in patients with locoregionally recurrent extranodal nasal-type NK/T cell lymphoma (NKTCL) and to determine the value of salvage radiotherapy.Forty-two patients with NKTCL who developed first locoregional recurrence with (n=13) or without (n=29) systemic failure were reviewed.Retreatment included chemotherapy (n=20), radiotherapy (n=13), and radiotherapy plus chemotherapy (n=9).Fifteen patients were reirradiated for localized recurrent disease.The 5-year overall survival (OS) rate after recurrence was 40 %, with a median survival of 26 months.The 2-year OS rate and median OS were 68 % and 36 months for locoregional recurrence only, compared with 31% and 14 months for both locoregional and systemic recurrence, respectively (p=0.034).Subgroup analysis for patients with localized recurrent disease revealed an improved OS with radiotherapy.The 2-year and 5-year OS rates were 77 and 69 % for radiotherapy, respectively, compared with a 2-year OS rate of 50 % and median OS of 16 months for chemotherapy alone (p=0.006).Patients with localized recurrence had a better prognosis than those with systemic recurrence.Salvage radiotherapy or reirradiation resulted in a favorable prognosis for patients with localized recurrent disease.