From 1956 through 1973, 82 patients with carcinoma of the nasopharynx received high dose megavoltage radiation therapy a t Stanford University. The actuarial disease-free (NED) survival was 62% a t 5 years and 56% a t 10 years.
The NED survivals a t 5 years for patients with T I , T2, and T3 lesions were 76%. 68%, and 55%, respectively. No T4 patients were salvaged, but two of 10 patients who presented with cranial nerve dysfunction were long-term survivors. The degree of nodal involvement also had prognostic significance. Involved lymph nodes were successfully controlled in all instances when doses of a t least 6500 rads were given. Initial treatment failed in 32 patients. In 24 (75%) this occurred within 18 months. Thirteen patients with initial recurrences i n head and neck sites were retreated and three remain alive. Survival after retreatment ranged from 2 months t o 10 years, with a median of 16 months. Although nearly one-third (6/17) of the patients with local recurrences had initial T1 or T 2 lesions, there have been no failures in patients treated for these early stages in the last 7 years. This may be attributed t o the use of larger treatment fields. Likewise, prophylactic irradiation of the neck was always successful in preventing nodal disease if the primary site was controlled.