Treatment outcome after radiotherapy alone for patients with Stage I–II nasopharyngeal carcinoma

The objective of this study was to review the long-term treatment outcome of patients with American Joint Committee on Cancer (AJCC) 1997 Stage I–II nasopharyngeal carcinoma (NPC) who were treated with radiotherapy alone. One hundred forty-one patients with NPC had AJCC 1997 Stage I–II disease (Stage I NPC, 50 patients; Stage II NPC, 91 patients) after restaging and were treated with radiotherapy alone between September 1989 and August 1991. Fifty-seven patients had lymph node disease, and the median greatest lymph node dimension was 3 cm. The median dose to the nasopharynx was 65 grays. The median follow-up was 82 months (range, 4–141 months). Patients who had Stage I disease had an excellent outcome after radiotherapy. The 10-year disease specific survival, recurrence free survival (RFS), local RFS, lymph node RFS, and distant metastasis free survival rates were 98%, 94%, 96%, 98%, and 98%, respectively. Patients who had Stage II disease had a worse outcome compared with patients who had Stage I disease: The corresponding 10-year survival rates were 60%, 51%, 78%, 93%, and 64%. The differences all were significant except for lymph node control. Among patients who had Stage II disease, those with T1–T2N1 NPC appeared to have a worse outcome compared with patients who had T2N0 NPC. No significant differences in survival rates were found with respect to lymph node size or status for patients with T1–T2N1 disease. When patients with NPC had their disease staged according to the AJCC 1997 classification system, patients with Stage I disease had an excellent outcome after they were treated with radiotherapy alone. Patients with Stage II disease, especially those with T1–T2N1 disease, had a relatively worse outcome, and more aggressive therapy, such as combined-modality treatment, may be indicated for those patients. Cancer 2003;98:74–80. © 2003 American Cancer Society. DOI 10.1002/cncr.11485