IMPACT OF CHANGES IN THE TREATMENT OF NASOPHARYNGEAL CARCINOMA - AN EXPERIENCE OF 30 YEARS

Two hundred and twenty-eight patients with nasopharyngeal carcinoma we re treated in a single institution in a 31-year period. Overall surviv al (OS), disease-free survival (DFS), and complete response (CR) rates were analyzed. In addition, survival and control rates from 1960 to 1 975 and from 1976 to 1991 were evaluated. In the latter group, a compa rative study was performed between patients treated with neoadjuvant c hemotherapy (NCT) before radiotherapy (RT) (45) and patients treated w ith radiotherapy alone (45). OS at 5 and 10 years were 42 and 34%, and DFS rates were 35 and 30%, respectively. CR was achieved in 184 patie nts (81%). Tumor progression and survival were strongly associated wit h T-category. Use of fashioned blocks, age and T-category were the mos t important factors influencing survival in a multivariate analysis. I n the patients treated with NCT, rates of CR and OS were not significa ntly different when compared with the concurrent RT alone group. Ninet y-nine patients had recurrence (54%) and 58 received rescue treatment. Modern radiotherapy techniques have greatly assisted in the improveme nt of tumor control rates. Chemotherapy must be further evaluated and new treatments for relapsed patients are needed.