Improved survival in carcinoma of the nasopharynx

Between 1970 and 1980, we treated 107 previously untreated patients with biopsy-proven carcinoma of the nasopharynx by megavoltage external radiation therapy to the primary site, base of the skull, and both sides of the neck. Eighty-seven percent of the patients had stage IV disease (American Joint Committee 1980), 53% had T4 primaries, and 73% had palpable cervical metastases. The histology was anaplastic or poorly differentiated carcinoma in 81%. The observed 5-year survival rate was 35% for the patients treated between 1970 and 1976, and increased to 72% for those treated between 1977 and 1980 (P less than 0.01). The two patient populations were similar except that the dose of irradiation (median and modal) to the primary site was 6,000 rad during 1970-1976 and 7,000 rad during 1977-1980. The survival rate was not significantly influenced by age, sex, birthplace, histology, or stage. These data suggest that a relatively high cure rate might be possible in carcinoma of the nasopharynx, even though most patients present with locally advanced disease. The patterns of relapse are discussed.