What Is the Treatment of Stage II Nasopharyngeal Carcinoma?

Stage II nasopharyngeal carcinoma represents locoregionally limited disease that is amenable to definitive radiotherapy-based treatment. The optimal approach depends on the radiotherapy technique available.

Clinical Scenario

This protocol addresses patients with Stage II nasopharyngeal carcinoma. Unlike more advanced stages, Stage II disease is managed with a focused, radiotherapy-centred strategy. The choice of radiation technique is the key determinant of whether systemic treatment is added concurrently.

Treatment Approach (Partial Overview)

For Stage II disease, precision radiotherapy — including intensity-modulated techniques — is central to the recommended first-line approach. Whether concurrent chemotherapy is incorporated depends on the specific radiation modality employed. Full details, including the role of each modality and the criteria that guide this decision, are in the complete protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2020.12.007

Stage I-II disease is treated by RT alone; for stage II disease, this approach is only used when IMRT is adopted [II, B].

Stage I disease is treated by RT alone, whereas patients with stage II NPC benefit from concurrent chemoradiotherapy (CRT) with cisplatin 30 mg/m2/week when 2D-RT is used [II, B]; a non-significant difference in survival outcomes was shown for CRT versus RT alone when IMRT was adopted [II, B].

A total dose of 70 Gy is needed for the eradication of macroscopic disease and 50–60 Gy for the treatment of potential at-risk sites, usually by conventional or moderately accelerated RT.

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