Malignant tumours of the nasopharynx: retrospective review of 74 cases.

Seventy-four patients with histologically confirmed malignant tumours of the nasopharynx were treated by the Departments of ENT and Radiotherapy of the Sint Radboud Academic Hospital, Nijmegen, The Netherlands. Selected prognostic factors were examined. The 5-year overall survival for the malignant epithelial tumours was 35%. The number of patients treated was too small to reach definite conclusions with respect to age and histology as prognostic factors. Staging, however, seems to be of value and it is suggested that the classification proposed in Kyoto, Japan, 1977 be adopted because it offers a better relationship between clinical staging and prognosis. From our data it appeared that treatment failure occurs mainly because of advanced initial tumour stage or distant metastasis; 40% of patients with initial locoregional control died because of distant metastasis. As half of the patients with distant metastasis presented with 'early' tumour stages (T1, T2, T3a), we strongly recommend adding systemic chemotherapy to the primary treatment of nasopharyngeal tumours.