Carcinoma of the nasopharynx in northern israel: Epidemiology and treatment results

Between 1968 and 1984, 49 patients with carcinoma of the nasopharynx were treated at the Northern Israel Oncology Center. There were 6 stage I–II patients (12%) and 43 stage III‐IV patients (88%). According to ethnic origin, there were 27 (55%) non‐Ashkenazi Jews, 9 (18%) Ashkenazi Jews, and 13 (27%) Arabs. This distribution is different from the percentages of these ethnic groups in Northern Israel. All patients received combined cobalt 60 and 8–10 MeV electron beam radiotherapy to the primary tumor and the entire neck. Twelve stage III‐IV patients received three courses of chemotherapy using bleomycin, methotrexate, and cisplatin (BMP) prior to definitive radiotherapy. The following 5‐yr actuarial survival figures were achieved: all patients, 42%; stage I‐II, 63%; stage III‐IV, 37%; Arabs, 53%, non‐Ashkenazi Jews, 47%; Ashkenazi Jews, 22%; BMP + radiotherapy, 54%; radiotherapy alone, 42%. It is concluded that there is an ethnic‐related pattern of nasopharyngeal carcinoma in Northern Israel. Prognosis is better in non‐Ashkenazi Jews and Arabs with early‐stage lymphoepithelioma or anaplastic carcinoma, younger than 45 yr old, and receiving more than 5,500 cGy. Chemotherapy by BMP improves initial control rates with questionable benefit to long‐term survival.