Intracavitary radiotherapy for nasopharyngeal carcinoma--palliation or cure?

: Although nasopharyngeal carcinoma is classically treated by external irradiation, the technique invariably results in decreased parotid secretions and rapid tooth decay. For the treatment of locally relapsed tumours, nasopharyngectomy, though effective, may not always be available for routine salvage, especially in endemic areas. A pilot study was made of ten patients having limited local relapses who were treated by intracavitary irradiation (ICI) with or without an abbreviated dose of external irradiation. With ICI alone, relapses outside the nasopharynx occurred in two patients but the combination with even an abbreviated dose of external irradiation was more successful. Nevertheless, even with relapse, patients were free from local symptoms for a median time of over two years--an excellent palliation result. More work, preferably at the multi-centre level, should be done to define more precisely the role of intracavitary irradiation for nasopharyngeal carcinoma.