Treatment outcome after radiotherapy alone for patients with Stage I-II nasopharyngeal carcinoma.
BACKGROUND
The objective of this study was to review the long-term treatment outcome of patients with American Joint Committee on Cancer (AJCC) 1997 Stage I-II nasopharyngeal carcinoma (NPC) who were treated with radiotherapy alone.


METHODS
One hundred forty-one patients with NPC had AJCC 1997 Stage I-II disease (Stage I NPC, 50 patients; Stage II NPC, 91 patients) after restaging and were treated with radiotherapy alone between September 1989 and August 1991. Fifty-seven patients had lymph node disease, and the median greatest lymph node dimension was 3 cm. The median dose to the nasopharynx was 65 grays. The median follow-up was 82 months (range, 4-141 months).


RESULTS
Patients who had Stage I disease had an excellent outcome after radiotherapy. The 10-year disease specific survival, recurrence free survival (RFS), local RFS, lymph node RFS, and distant metastasis free survival rates were 98%, 94%, 96%, 98%, and 98%, respectively. Patients who had Stage II disease had a worse outcome compared with patients who had Stage I disease: The corresponding 10-year survival rates were 60%, 51%, 78%, 93%, and 64%. The differences all were significant except for lymph node control. Among patients who had Stage II disease, those with T1-T2N1 NPC appeared to have a worse outcome compared with patients who had T2N0 NPC. No significant differences in survival rates were found with respect to lymph node size or status for patients with T1-T2N1 disease.


CONCLUSIONS
When patients with NPC had their disease staged according to the AJCC 1997 classification system, patients with Stage I disease had an excellent outcome after they were treated with radiotherapy alone. Patients with Stage II disease, especially those with T1-T2N1 disease, had a relatively worse outcome, and more aggressive therapy, such as combined-modality treatment, may be indicated for those patients.
Chua
Daniel T T
DT
Department of Clinical Oncology, the University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
Sham
Jonathan S T
JS
Kwong
Dora L W
DL
Au
Gordon K H
GK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011829:Radiation Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome