Between 1968 and 1984, 49
patients with carcinoma of the nasopharynx were treated at the Northern Israel Oncology Center. There were 6 stage 1-11 patients (12%) and 43 stage III-rV patients (88%). According to ethnic origin, there were 27 (55%) non-Ashkenazi Jews, 9 (18%) Ashkenazi Jews, and 13 (27%) Arabs. This distribution is different from the percentages of these ethnic groups in Northern Israel. All patients received combined cobalt 60 and 8-10 MeV electron beam radiotherapy to the primary tumor and the entire neck. Twelve stage III-IV patients received three courses of chemotherapy using bleomycin, methotrexate, and cisplatin (BMP) prior to definitive radiotherapy. The following 5-yr actuarial survival figures were achieved: all patients, 42 % ; stage I-11, 63 % ; stage 111-IV, 37%; Arabs, 53 %, non-Ashkenazi Jews, 47%; Ashkenazi Jews, 22 % ; BMP +radiotherapy, 54 % ; radiotherapy alone, 42 % . It is concluded that there is an ethnic-related pattern of nasopharyngeal carcinoma in Northern Israel. Prognosis is better in non-Ashkenazi Jews and Arabs with early-stage lymphoepithelioma or anaplastic carcinoma, younger than 45 yr old, and receiving more than 5,500 cCy. Chemotherapy by BMP improves initial control rates with questionable benefit to long-term survival.