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Nasopharyngeal carcinoma (NPC) of the endemic type (World Health Organization [WHO] type II and III) is considered separately from head and neck squamous cell cancer (HNSCC) because of certain distinctive features that confer a different biological behavior in terms of treatment responses and disease outcome. The most important feature that probably accounts for this difference is its strong association with the Epstein-Barr virus (EBV) (1-]3). This virus is probably the key etiological agent in the pathogenesis of this cancer, with genetic predisposition and other environmental factors as important cofactors (4-13). This is in line with the peculiar geographic distribution and racial predilection of this disease. [ABSTRACT FROM AUTHOR]