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Cancer of the nasopharynx

because this is an uncommon cancer much of the data is old, using radiation alone:
   local control stats and survival stats
   large series treated with radiation alone

Meta-analysis showed that adding chemotherapy to radiation reduced the death rate by 18% and tumor failure/death by 24%. With combined chemoradiation the survival even with advanced cases is in the 70% range. Most patients are now treated with chemo plus IMRT similar to the RTOG 0225 trial (go here). The new RTOG 0615 trial adds Avastin to chemoradiation (go here).

See recent treatment studies, summary chemo-radiation

see radiation port field#1, #2, #3
 radiation isodose #1 , #2, #3, #4, #5

The five-year overall survival for NPC according to disease stage in a contemporary case series was 90, 84, 75, and 58 percent for stage I through IV, respectively. In addition to prognostic factors of T and N stage and location of neck nodes (above or within the supraclavicular fossa), pre- and posttherapy Epstein-Barr Virus (EBV) DNA levels have prognostic significance, with higher levels conferring a worse prognosis, stage for stage Five-year survival rates according to UICC/AJCC stage grouping and pretherapy EBV DNA levels from one case series are as follows:

  • Stage I, II disease, low DNA - 91 percent

  • Stage I, II disease, high DNA - 64 percent

  • Stage III, IV disease, low DNA - 66 percent

  • Stage III, IV disease, high DNA - 54 percent

Older Data Below
Control Rates Controlled by Radiation by Tumor Stage
T1 T2 T3 T4
67-79% 54-94% 37-78% 42-71%

Control of Neck Nodes by Radiation
N0 N1 N2 N3
82 - 100% 86 - 92% 87 - 88% 82 - 89%

5 Year Survival by T Stage
T1 T2 T3 T4
60 - 76% 48 - 68% 27 - 55% 0 - 29%

5 Year Survival by Nodes Stage
N0 N1 N2 N3
42 - 78% 27 - 70% 42 - 52% 27 - 39%