Regional Stage IV carcinoma of the nasopharynx treated by aggressive radiotherapy.

Between January 1, 1969 and December 31, 1981, 45 patients received radiotherapy for advanced (Stage IV) carcinoma of the nasopharynx confined to the head and neck at New York University Medical Center. Forty of these 45 patients received at least 6000 cGy. The 5 and 10 year actuarial survival rates were 31 and 20%. Four patients are currently alive without evidence of disease at least 10 years after treatment. Local persistence or recurrence of tumor in the nasopharynx was the primary cause of failure and occurred in 42% of our patients. The likelihood of this type of treatment failure correlated with the initial "T stage" of disease. Inability to control nodal disease was less common, occurring in 23% of evaluable patients and was proportional to the "N stage." Distant metastases became apparent in 13% of our patients and correlated with the "N stage." More than 90% of recurrences were evident within two and all occurred within three years of treatment.