Nasopharyngeal Carcinoma in Non-endemic Populations

Nasopharyngeal carcinoma (NPC) is distinct among cancers of the head and neck by virtue of its etiopathogenic relationship to the Epstein-Barr virus (EPV), its geographic concentration in southeastern Asia, and its relatively unique pathologic classification, staging system, clinical presentation, natural history, and response to both radiotherapy and chemotherapy. This chapter focuses on NPC in the geographic areas of sporadic incidence, for example, North America, Europe, Australia, where the tumor is rare. By necessity, these data are compared and contrasted with the large body of evidence from studies of endemic disease. Recent advances in treatment of the patient with locoregionally advanced NPC are fully reviewed, with an emphasis on intensity-modulated radiotherapy and concurrent chemoradiation.