title: Analysis of failures after definitive irradiation for epidermoid carcinoma of the nasopharynx.
abstract: From 1955 to 1976, 111 patients were treated with definitive radiotherapy for epidermoid carcinoma of the nasopharynx. There was a definite correlation between recurrence at the primary site and T-stage; 9.5% of T1-2 patients, 38.1% of T3 patients and 54.1% of T4 patients had local recurrences. Similarly, failure in the neck correlated with N-stage, being negligible for N0 and N1 but 28.6% for N2 and 36.1% for N3. The incidence of distant metastases had no correlation with T-stage but correlated very closely with N-stage. The patients were grouped into four T and N categories, T1-2 N0-1, T1-2 N2-3, T3-4 N0-1, and T3-4 2-3. The five year relapse-free survival for the T1-2 N0-1 category was 69% but was only about 20% for each of the other three categories. The major cause of poor survival for the T3-4 N0-1 category was recurrence at the primary site, whereas for the T1-2 N2-3 and T3-4 N2-3 categories, it was the high incidence of distant metastases, approximately 50%. Recommendations are to increase dose at the primary site for T3-4 N0-1 patients and to institute clinical trials testing adjuvant chemotherapy for patients with neck stages N2 and N3.
mesh_terms: D000206:Actuarial Analysis; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008207:Lymphatic Metastasis; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies