CLINICAL AND EVOLUTIVE ASPECTS OF NASOPHA RYNGEAL T4 NO

Nasopharyngeal carcinoma (NPC) is the primary cancer of the head and n eck localisations in the Salah Azaiz Institute (Tunisia). From 1970 to 1987, 80 patients with histologically proven T4 N0 NPC, were treated with exclusive radiation (70-75 Gy to the primary lesion and 50-55 Gy to cervical lymph nodes). The T4 N0 represents 7% of all NPC and 16% o f the T4 treated in our Institute. Ninety percent of the patients are over 20 years old with a mean age of 52 years. The sex-ratio was 4:1. Extension to the brain was observed in 55% of the cases. Local control was 70% at 2 months after the end of irradiation. The actuarial survi val at 5 years was 47%. Distant metastasis represent 13% (30% for all NPC). The main failure of treatment was local recurrence. The T4 N0 is probably a particular entity concerning the age, the response to radi otherapy and the low rare of distant metastasis.