Radiation management of advanced nasopharyngeal cancer

During the period from 1957-1976, 70 patients with advanced malignant tumors of nasopharynx were treated by irradiation in the Department of Radiation Therapy, University of Maryland Hospital. Forty-nine patients were treated with curative intent and 21 patients with palliative purpose. Of 49 patients treated for cure, 22 (45%) survived disease-free for at least 5 years. Local control was achieved best (92%) by combined treatment, external beam and brachytherapy. Factors responsible for local control and disease-free survival, appear to be related to clinical staging (primary and nodal disease), cell types and treatment used. In spite of aggressive radiation treatment for advanced cases (Stages III and IV), distant disease is still a major problem and will necessitate further trial by combined chemotherapeutic treatment with irradiation. This article highlights the results and failures of the technique of the irradiation, both external and brachytherapy. It is suggested that aggressive radiation treatment using a combined approach (external beam and brachytherapy, whenever possible) be done in all cases for cure. Palliative treatment can only offer a short-term symptom-free status in 72% of all cases treated.