Dr. Jafek' has raised several pertinent points in his editorial comment on my paper "Relative Risk Factors in the Treatment of Juvenile Nasopharyngeal Angiofibroma" (Head & Neck Surg 3:21-26, 19801. ' I would of course agree that if the rates of cure by different treatment modalities are not equivalent, then a comparison of other aspects of treatment, including toxicity, may be irrelevant. However, the Toronto group' are not alone in their ability to control a significant proportion of patients with juvenile nasopharyngeal angiofibroma by radiation therapy. The Stockholm group3 obtained control for 5 years or longer in 38 (86%) of 44 patients. While these investigators established the curability of juvenile nasopharyngeal angiofibroma by radiation therapy, many patients were treated prior to the development of modern radiation apparatus, and that center abandoned radiation therapy because the techniques and high radiation doses which had been used were associated with unacceptable late morbidity. Although Car-valho4 described control by primary radiation therapy and hormone therapy in only 11 (52%) of 21 patients (8 patients were controlled following 1 course of radiation therapy, 3 patients were controlled following 2 courses, and 2 patients who received second courses of treatment are not yet evaluable), it should be remarked that many of these patients had very large tumors. The same authors obtained control by surgery alone in only 4 of 8 cases specifically selected for such treatment because they had small tumors. Their 4 failures following surgery were controlled by subsequent radiation therapy. The Toronto result^,^ with 80% control following 1 course of treatment with 3,000-3,500 rad in 3 weeks, and 94% control following 2 courses, have been achieved in a wide spectrum of patients, and 26 of 29 patients investigated by both arteriography and tomography showed bone erosion of varying extent. I do