Clinical outcomes for early‐stage nasopharyngeal carcinoma with predominantly WHO II histology treated by intensity‐modulated radiation therapy with or without chemotherapy in nonendemic region of China

Background The clinical outcomes for early‐stage nasopharyngeal carcinoma (NPC) in northwest China were evaluated. Methods A retrospective study was performed from 69 patients with NPC patients treated with intensity‐modulated radiation therapy (IMRT) with or without chemotherapy. Results Median follow‐up was 34 months. World Health Organization (WHO) type II was the predominant histology (71%). All treatment failures occurred in T2N1 NPCs (14.5%), with metastasis the major reason. The 3‐year overall survival (OS), local recurrence–free survival (LRFS), and distant metastasis–free survival (DMFS) were 93.3%, 94.1%, and 94.8% respectively. The 3‐year survival rate for T2N1 and IMRT alone group were both significantly poorer than the T1N0, T2N0, and T1N1 groups and the chemoradiation group, respectively ( p < .05). N1 classification, T2N1 classification, and addition of chemoradiation were significant independent predictors ( p < .05). No grade IV toxicities were observed. Conclusion T2N1 classification is a unique subgroup with higher risk of distant metastasis. Improved outcomes of T2N1 NPC with predominantly WHO II histology after chemoradiation has not been reported. © 2013 Wiley Periodicals, Inc. Head Neck 36: 841–847, 2014