Treatment of Nasopharyngeal Cancer: Raising the “Barr”

Nasopharyngeal carcinoma (NPC) is distinguished from other head and neck malignancies by virtue of its unique clinical and pathologic characteristics. NPC is an epithelial tumor with a distinct geographic distribution that is uncommon in Europe and North America but common in southern China (1). Multiple factors play a role in the pathogenesis of NPC, including genetic predisposition, environmental factors, and Epstein-Barr virus (EBV) infection (2–4). Histopathologically, NPC is separated into the following three categories by the World Health Organization (WHO) (1,5): 1) keratinizing squamous-cell carcinoma similar to other head and neck tumors (type I); 2) nonkeratinizing epidermoid carci-noma (type II); and 3) undifferentiated carcinomas referred to as lymphoepithelioma or Schminke tumors (type III) (1). In most parts of the world, NPC occurs sporadically due to both geneti