[Medical treatment of nasopharyngeal cancers].

Nasopharyngeal cancers are essentially epidermoids (NPC) and dominated by the undifferentiated type (UCNT) in endemic areas. The standard treatment of NPC remain external beam radiotherapy but the results are poor in T3-4 lesions locally advanced (30-40% on event- free survival vs 80-90% in T1-T2) explained by a higher rate of relapse and metastases. Improvement of therapeutic results occurs with addition of chemotherapy to radiotherapy, specially with the concomitant scheme (weekly cisplatin), with an increase of overall and diseasefree survivals for the advanced stages (Meta-analysis data). Despite these progresses, we have to evaluate the risk of long term sequelae of combined therapies in children and adolescents. We are observing however an epidemiologic transition with the increase of more localized cases in term of T and N disease.