Incidence: Nasopharyngeal cancer (NPC) is a rare disease in Caucasians and is commonly WHO Type 1 (squamous cell carcinoma) histology. NPC is endemic in southern China (the Guangdong Province), Hong Kong and Taiwan, and is usually WHO Type 3 (undifferentiated) histology. These differing patient cohorts and different staging systems have hampered the rate of progress in optimizing the management of NPC patients. Changing demographics: Melbourne's population demographics have changed significantly since 1985. Our NPC population currently bridges the endemic and non-endemic populations. Treatment: There have been major improvements in radiation therapy techniques. The optimal conformal radiation technique(s) to be used if IMRT is not available is discussed. Concurrent chemotherapy and radiation therapy (chemoradiation) is the current standard of treatment in NPC. The role of additional sequential chemotherapy is controversial. A randomized trial comparing induction chemotherapy and chemoradiation versus chemoradiation alone would be very informative.
