Induction chemotherapy followed by alternating chemo-radiotherapy in stage IV undifferentiated nasopharyngeal carcinoma

In locally advanced undifferentiated nasopharyngeal carcinoma (UNPC), concomitant chemo-radiotherapy is the only strategy that gave better results over radiation alone in a phase III trial. Adding effective chemotherapy to a concomitant chemo-radiotherapy programme may be a way to improve the results further. 30 patients with previously untreated T4 and/or N2-3 undifferentiated nasopharyngeal carcinoma were consecutively enrolled and initially treated with 3 courses of epidoxorubicin, 90 mg/m2, day 1 and cisplatin, 40 mg/m2, days 1 and 2, every 3 weeks. After a radiological and clinical response assessment patients underwent 3 courses of cisplatin, 20 mg/m2/day, days 1-4 and fluorouracil, 200 mg/m2/day, days 1-4, i.v. bolus, (weeks 1, 4, 7) alternated to 3 courses of radiation (week 2-3, 5-6, 8-9-10), with a single daily fractionation, up to 70 Gy. WHO histology was type 2 in 30% and type 3 in 70% of the patients. 57% had T4 and 77% N2-3 disease. All the patients are evaluable for toxicity and response. All but one received 3 courses of induction chemotherapy. Toxicity was mild to moderate in any case. At the end of the induction phase 10% of CRs, 83.3% of PRs and 6.7% of SD were recorded. All the patients but one had the planned number of chemotherapy courses in the alternating phase and all received the planned radiation dose. One patient out of 3 developed grade III-IV mucositis. Haematological toxicity was generally mild to moderate. At the final response evaluation 86.7% of CRs and 13.3% of PRs were observed. At a median follow-up of 31 months, 13.3% of patients had a loco-regional progression and 20% developed distant metastases. The 3-year actuarial progression-free survival and overall survival rates were 64% and 83%. Induction chemotherapy followed by alternating chemo-radiotherapy is feasible and patients' compliance optimal. This approach showed a very promising activity on locally advanced UNPC and merits to be investigated in phase III studies.     

Induction chemotherapy with cisplatin and epirubicin followed by radiotherapy and concurrent cisplatin in locally advanced nasopharyngeal carcinoma observed in a non-endemic population

Background and purpose

Chemoradiotherapy (CRT) represents the main therapy choice in the treatment of locoregionally advanced nasopharyngeal carcinoma (NPC). The aim of this study was the clinical evaluation of neoadjuvant chemotherapy (NACT) followed by CRT in a non-endemic population affected by advanced NPC.

Materials and methods

Patients with locoregionally advanced NPC were treated with three cycles of induction chemotherapy (CHT) with cisplatin (100 mg/m²) plus epirubicin (90 mg/m²), followed by cisplatin (100 mg/m²) and concomitant radiotherapy (70 Gy).

Results

In 40 patients treated with such protocol, after the completion of induction CHT and CRT we observed the objective response rates of 90% and 100%, respectively. Treatment tolerability and toxicity were easily controllable. With a median follow-up time of 54 months, 3- and 5-year disease-free survival was 75% and 65% and 3- and 5-year overall survival was 84% and 77%.Three- and 5-year locoregional control was 82% and 70%, and 5-year distant metastases free survival was 75%.

Conclusions

NACT with cisplatin and epirubicin followed by concomitant CRT represents a feasible, efficient treatment for patients with advanced NPC. This regimen ensures an excellent locoregional disease control and overall survival with a low incidence of distant metastases.     

局部晚期鼻咽癌放疗与化疗综合治疗的生存分析

目的探讨局部晚期鼻咽癌放化综合治疗疗效和毒副反应。方法回顾性分析77例经病理证实鼻咽癌患者。年龄17～74岁,男:女=3.8:1。1992年福州分期T1、12、T3、T4期分别为11、33、22、11例,N0、N1、N2、N3期分别为7、15、44、11例。临床分期Ⅲ期56例,ⅣA期21例。所有患者放疗前接受诱导化疗1～3个疗程:顺铂20 mg/m~2,氟尿嘧啶500 mg/m~2,其中62例应用甲酰四氢叶酸钙100 mg/m~2,均为第1～3天,2周后重复。化疗结束后2周内放疗:鼻咽原发病灶均采用~(60)Co照射1.8～2.0 Gy/次,总剂量64～78 Gy;57例采用面颈联合野 耳前野 鼻前野治疗,20例采用耳前野 鼻前野照射,9例采用耳后野加量6～8 Gy分3～4次,13例给予颅底小野补量4～8 Gy分2～4次;颈部放射源用~(60)Co、180 kV X线和9 MeV电子束,N0期患者仅照射上颈部,有颈部转移者照射全颈,预防剂量50～55 Gy,根治剂量60～68 Gy;1例外照射结束后因鼻咽腔内肿瘤残留,给予后装治疗2次,间隔1周,10 Gy/次)。放疗结束后3周给予辅助化疗:顺铂20 mg/m~2,氟尿嘧啶500 mg/m~2,甲酰四氢叶酸钙100 mg/m~2,均为第1～3天,3周后重复,共2～4疗程。结果中位随访60个月,5年总生存率、无瘤生存率、无复发生存率、无远处转移生存率分别为68%、58%、81、75%。≥4个化疗周期与≤3个化疗周期生存曲线比较差异无统计学意义(X~2=0.05,P=0.831)。主要急性反应有血液学毒性:1级11例,2级7例,3级2例;黏膜炎:2级33例,3级20例,4级1例;消化道反应:1级21例,2级11例,3级1例;皮肤反应:2级30例,3级4例。晚期损伤:1例发生放射性脑损伤,无其他颅神经损伤发生;张口困难轻度4例,中度1例;听力减退轻度31例,中度7例,严重1例。化疗周期≥4个与≤3个的听力损伤差异有统计学意义(z=2.06,P=0.039)。绝大多数放疗结束后都有程度不等的口干,随访中都明显好转,至末次随访时轻度口干13例,中度3例。结论以顺铂和氟尿嘧啶为基础的诱导化疗 放疗 辅助化疗局部晚期鼻咽癌的疗效较单纯放疗无明显提高,但可能加重患者听力的晚期损伤。     

晚期鼻咽癌的诱导化疗联合放射治疗

目的：研究诱导化疗联合放射治疗Ⅲ、Ⅳ期鼻咽癌的疗效。方法：对50例Ⅲ、Ⅳ期鼻咽癌诱导化疗加放射治疗（CT／RT组）。并选取同期在本院行单纯放射治疗的50例Ⅲ、Ⅳ期鼻咽癌作为对照（RT组）。结果：五年局控率CR／RT组与RT组分别为61．2％及68．75;五年远处转移发生率CT／RT组与RT组分别为15．2％及27．4％;N2、N3期病人CT／RT组与RT组五年远处转移发生率分别为27．4％和43．85;CT／RT组与RT组五年生存率分别为57．8％和51．6％（P＝0．61）;N2、N3期病人CT／RT组与RT组5年生存率分别为60．6％和26．3％（P＝0．033）;T3、T4期病人CT／RT组与RT组五年生存率分别为36．8％和41．2％（P＝0．80）;两组放射治疗期间急性口腔粘膜发生率相似,Ⅰ、Ⅱ级骨髓抑制及胃肠道反应等副作用诱导化疗组较单纯放疗组稍重,但经对症处理后患者均能耐受,两组均无严重后期并发症。论：诱导化疗未能提高、Ⅲ、Ⅳ期鼻另癌病人五年生存率及局控率,但降低了N2、N3期病人的远处转移发生率,提高了N2、N3现人的五年生存率。     

Induction chemotherapy followed by radiotherapy in the treatment of anal cancer

This study was conducted to investigate the efficacy of the induction chemotherapy followed by radiotherapy in anal cancer. Twenty-three patients diagnosed with anal cancer between March 1991 and February 1999 were treated with induction chemotherapy with 5-fluorouracil based regimens followed by external beam radiation. After a median follow-up of 78 months, the overall survival and the disease-free survival at 5 years was 71.3 and 67.5%, respectively. The colostomy-free survival at 5 years was 91%, as the inguinal lymph nodes were the most frequent site of relapse. Serious side effects did not occur and late complications did not develop either. Induction chemotherapy followed by radiotherapy in patients with anal cancer is effective in terms of its response and preserving the anal sphincter without serious acute and late complications.     

Induction chemotherapy followed by concurrent chemotherapy and high-dose radiotherapy for locally advanced squamous cell carcinoma of the upper-thoracic and midthoracic esophagus

The purpose of this study was to evaluate the efficacy and toxicity of an induction chemotherapy schedule followed by high-dose radiotherapy and concurrent chemotherapy for locally advanced squamous cell carcinomas of the upper and midthoracic esophagus. Patients were treated with three courses of fluorouracil, leucovorin, etoposide, and cisplatin-containing induction chemotherapy followed by high-dose external beam radiotherapy to 65 Gy in 6 weeks for T4 and obstructing T3 tumors. Transversable T3 tumors received 60 Gy in 6 weeks by external radiotherapy, followed by two high-dose-rate esophageal brachytherapy fractions of 4 Gy in 5-mm tissue depth. Concurrent to radiotherapy, cisplatin and etoposide were given. Long-term survival of 22 patients was 41% and 31% at 2 and 3 years, respectively, with a median follow-up of 39 months. The probability of locoregional tumor recurrence was 60% at 3 years for all patients and 30% for those with a partial or complete response to induction chemotherapy. Acute toxicity of this schedule was moderate. Long-term survivors had a good swallowing function. This schedule offers a considerable chance of long-term survival for patients with locally advanced squamous cell carcinomas of the upper and midthoracic esophagus. Local in-field recurrences are the main risk after definitive radiochemotherapy. Dose escalation of radiotherapy is possible because of the observed low late toxicity.     

Induction platinum-based chemotherapy followed by radical hyperfractionated radiotherapy with concurrent chemotherapy in the treatment of locally advanced non-small-cell carcinoma of the lung

This study evaluated tolerance, local control, and short-term survival in patients with locally advanced non-small-cell lung carcinoma treated with induction chemotherapy followed by radical hyperfractionated radiotherapy with concurrent chemotherapy. Thirty-one patients with stage IIIa (N2) or IIIb tumors were treated with cis-platinum-based induction chemotherapy for 1 to 4 courses followed by radical hyperfractionated radiotherapy (69.6 Gy) with concurrent chemotherapy given at the beginning and end of radiotherapy. Induction chemotherapy produced no complete responses and 18 (58%) partial responses. After completion of radiotherapy, 4 patients had complete response (13%) and 23 patients (74%) partial response. The patterns of failure were as follows: intrathoracic, 6 patients (22%); intrathoracic + distant metastasis, 6 patients (22%); distant metastasis without thoracic failure, 5 patients (19%). Six patients of the 12 with intrathoracic failure experienced in-field radiotherapy pure local failure. At the time of this analysis, 10 patients were alive and well (4 complete and 6 partial responders). Actuarial survival projected at 39 months is 35%. No benefit was observed for those patients responding to induction chemotherapy. Toxicity was as follows: grade III neutropenic fever in 4 patients (13%), grade IV neutropenia in 13 patients (42%), pneumonia in 6 patients (19%), grade III esophagitis in 4 patients (13%) and severe clinical pneumonitis in 1 patient (3%). Induction chemotherapy followed by chemoradiotherapy is feasible, and the preliminary results are encouraging. Complete response after radiotherapy appeared to be related to short-term disease-free survival, and decisions based on the response to chemotherapy may be equivocal.     

Induction chemotherapy followed by chemoradiotherapy for the patients with far-advanced nasopharyngeal carcinoma - our treatment strategy

Nasopharyngeal carcinoma(NPC)is a rare malignant neoplasm arising from the head and neck region that affects less than 1 per 100, 000 in the Japanese population. NPC is a highly radiosensitive and chemosensitive cancer when compared to other head and neck cancers. Its treatment has mainly been developed by using radiotherapy and chemotherapy, rather than surgery. The standard of care now calls for radiotherapy alone for early-stage patients, and chemoradiotherapy for the advanced stages. Despite its sensitivity to treatments, survival rates of patients with Stage IV A, IV B, N 2/3 have been inadequate. The effectiveness of triplet-regimen induction chemotherapy for patients with locally advanced head and neck cancer has recently been reported. Since 2009, we have tried to improve survival by treating patients with triplet-regimen induction chemotherapy consisting of docetaxel, cisplatin and S-1, followed by cisplatin-based chemoradiotherapy. This treatment strategy has dramatically improved both overall survival and the complete response rate. Although it is a very promising treatment, it is highly toxic at the same time. We have experienced more than a few hematological and non-hematological grade 3/4 toxicities. Therefore, when conducting a treatment, considering its indication and building a sufficient back-up system are very important.     

Concurrent chemoradiotherapy followed by adjuvant chemotherapy in Asian patients with nasopharyngeal carcinoma: toxicities and preliminary results.

PURPOSE: Nasopharyngeal carcinoma (NPC) is endemic in Singapore. Nearly 60% of the patients diagnosed with NPC will present with locally advanced disease. The North American Intergroup study 0099 reported improved survival outcome in patients with locally advanced NPC who received combined chemoradiotherapy when compared to radiotherapy alone. Hence we explored the feasibility and efficacy of a similar protocol in our patients. METHODS AND MATERIALS: Between June 1996 and December 1997, 57 patients were treated with the following schedule as described. Radical radiotherapy (RT) of 66-70 Gy to the primary and neck with cisplatin (CDDP) 25 mg/m2 on days 1-4 given by infusion over 6-8 hours daily on weeks 1, 4, and 7 of the RT. This is followed by a further 3 cycles of adjuvant chemotherapy starting from week 11 from the first dose of radiation (CDDP 20 mg/m2/d and 5-fluorouracil [5-FU] 1 gm/m2/d on days 1-4 every 28 days). RESULTS: The majority of patients (68%) had Stage IV disease. About 54% of patients received all the intended treatment; 75% received all 3 cycles of CDDP during the RT phase and 63% received all three cycles of adjuvant chemotherapy. The received dose intensity of CDDP and 5-FU of greater than 0.8 was achieved in 58% and 60% of the patients respectively. Two treatment-related deaths due to reactivation of hepatitis B and neutropenic sepsis respectively, were encountered. At median follow-up of 16 months, 14 patients had relapsed, 12 systemically and 2 loco-regionally. CONCLUSION: Due to the acceptable tolerability of such a protocol in our cohort of patients, we have embarked on a Phase III study to confirm the results of the 0099 Intergroup study in the Asian context.     

Nasopharyngeal carcinoma: 30-year experience of a single institution in a non-endemic area

Purpose

Over the past years, radiotherapy techniques have changed significantly. The impact of these changes in the management of nasopharyngeal carcinoma (NPC) has not been fully evaluated.

Methods/patients

Between 1984 and 2014, 223 NPC were diagnosed in our hospital. Prior to 2000, patients were treated with 2D treatment plan (RT2D) that evolved to 3D schemes thereafter (RT3D).

Results

Tumors in the RT3D period showed significantly lower stages than those in the RT2D period. 5-year cause-specific survival improved from 55.7% (95% CI: 46.7–64.7%) in the RT2D period to 78.7% (95% CI: 68.7–88.7%) in the RT3D period (P = 0.006). This difference was greater for non-keratinizing NPC, where specific survival went from 63.2% (95% CI: 52.2–74.2%) to 84.4% (95% CI: 74.4–94.4%) (P = 0.014).

Conclusion

Recent changes in treatment strategies including concurrent chemoradiation and 3D radiotherapy may have impacted in better survival for NPC. Improved imaging techniques may have contributed by earlier detection and better treatment planning.

     

Neoadjuvant chemotherapy followed by radiotherapy in epidermoid carcinoma of anus

AIM AND BACKGROUND: The purpose of this study was to analyze the efficacy of neoadjuvant fluorouracil-cisplatin chemotherapy combined with radiotherapy for anal cancer. METHODS: Fourteen patients with epidermoid carcinoma of the anal canal were analyzed. Treatment consisted of three cycles of 5-fluorouracil (1000 mg/m2 bolus on days 1-5) and cisplatin (60 mg/m2 bolus on day 1) followed by 50.4 Gy to the pelvis and perineum over 5.5 weeks. Both inguinal lymphatics were irradiated with an identical dose schedule. The median follow-up was 78 months. RESULTS: Five-year overall survival rate and sphincter preservation rate was 85.1% and 85.7%, respectively. Response to chemoradiotherapy was the only significant factor with univariate analysis (P = 0.031). There were no complications of RTOG grade 3 or higher. CONCLUSIONS: Neoadjuvant chemotherapy with a cisplatin-based regimen rather than concurrent regimen plus radiotherapy may decrease complications without compromising survival or sphincter preservation.     

Randomized study of zorubicin versus zorubicin-cisplatin in undifferentiated carcinoma of the nasopharynx (UCNT)

Background: The most active chemotherapy regimens in UCNT were thosecombining anthracyclines (doxorubicin or epirubicin) and cisplatin. Ourprevious pilot study on 37 patients treated with thezorubicin–cisplatin combination with a RR of 67% and literaturedata about other anthracyclines such as epirubicin achieving a response rateof over 50% were the basis of this randomized study comparingefficacy and toxicity of the combination vs. zorubicin as monotherapy.Patients and methods: A total of 80 patients entered the study. Thediagnosis of UCNT was confirmed by two independent pathologists. Allpatients had their primary tumors in the nasopharynx. The patients wererandomized in two groups: group A (zorubicin 325 mg/m², day1), and group B (zorubicin 250 mg/m², day 1 and cisplatin 30mg/m², days 2–5). The inter-cycle interval was fourweeks. The two groups were well balanced according to sex, age, stage Ho andTNM stage.Results: Group A: 40 patients included, 34/40 evaluable for activity.Activity on evaluable patient basis: CR 4/34 (11.75%), PR 4/34, SD14/34, PD 12/34, response rate 8/34 (23.5%); response rate on intentto treat basis 8/40 (20%). Toxicity: granulocytopenia grade 3–46/40, thrombocytopenia grade 3–4 2/40, no febrile neutropenias,nausea/vomiting any grade 3/40, cardiac toxicity any grade (rhythm) 3/40other toxicities minor or absent. Group B: 40 patients included, 36/40evaluable for activity. Activity on evaluable patient basis: CR 10/36(27.78%), PR 17/36, SD 3/36, PD 6/36, response rate 27/36(75%); response rate on intent to treat basis 27/40 (67.5%).Toxicity: granulocytopenia grade 3–4 10/40, thrombocytopenia grade3–4 8/40, two febrile neutropenias, nausea/vomiting any grade 13/40,other toxicities mild or absent. Of the group of patients achieving a CR,four relapsed following 7, 11, 22 and 23 months, one was lost to follow-up,one died after six months from fulminant hepatitis B and eight are incomplete remission lasting for 30+ to 66+ months. Following CR achievementnone received any consolidation radiotherapy, and the projected five yearsof freedom from relapse for complete responders is about 60%.Conclusion: Zorubicin is an effective drug in UCNT and its combinationwith cisplatin has a significant activity and an acceptable toxicity.     

Combination of chemotherapy and radiotherapy in limited small cell lung carcinoma: results of alternating schedule in 109 patients

One hundred nine patients with limited small cell lung carcinoma were entered in a phase II study of treatment consisting of alternating 6 cycles of combination chemotherapy and 3 courses of mediastinal radiotherapy. Chemotherapy consisted of 40 mg doxorubicin/m2 on day 1; 75 mg etoposide/m2 on days 1, 2, and 3; 300 mg cyclophosphamide/m2 on days 3, 4, 5, and 6; and 400 mg methotrexate/m2 on day 2 (plus folinic acid rescue) or 100 mg cisplatin/m2 on day 2. The total mediastinal radiation dose was 45 or 55 Gy. A 6- to 8-cycle maintenance chemotherapy followed this induction protocol. The complete remission rate at the end of the induction therapy was 79%. The local recurrence rate was 25%, and the distant metastases rate was 52%. Median survival is 17.2 +/- 1.2 months and survival rate at 3 years is 26%. Lethal toxicity occurred in 3% of the patients, and long-term survivors are being evaluated. Our results justify further investigations with this alternating schedule.     

Preliminary results of chemo-radiotherapy followed or not by active immunotherapy of stage III and IV lymphosarcoma and reticulosarcoma

Summary We treated 101 patients with advanced (stage III and IV) lymphosarcoma and reticulosarcoma at first presentation of the disease or in relapse according to a protocol combining initial chemotherapy, complementary radiotherapy on icebergs, supplementary chemotherapy, and, finally, active immunotherapy.The overall complete remission rate was about 79% for lymphosarcoma and 73% for reticulosarcoma. About 50% of the patients were still in remission in each of the two diseases at 2 years; 60% of lymphosarcoma and 44% of reticulosarcoma patients achieved 2-year survival.This study shows the prognostic value of the WHO classification for lymphosarcoma and reticulosarcoma: the prognosis of prolymphocytic (centrofollicular) lymphosarcoma is far better than that of the lymphoblastic type, which is in turn better than that of the very poor prognosis of the immunoblastic type. The prognosis of reticulosarcoma is intermediate between that of the best-prognosis and that of the poorest-prognosis type of lymphosarcoma.     

Induction chemotherapy with paclitaxel and cisplatin, followed by concomitant cisplatin and radiotherapy for the treatment of locally advanced nasopharyngeal carcinoma

PURPOSE: To evaluate the efficacy and outcome of neoadjuvant paclitaxel and cisplatin chemotherapy followed by concurrent cisplatin and irradiation in patients with locally advanced nasopharyngeal (NP) squamous cell carcinoma. PATIENTS AND METHODS: The trial included 36 patients with locally advanced nasopharyngeal squamous carcinoma presented to Radiation Oncology and Otolaryngology departments-Ain Shams university hospitals, and Sohag Cancer Center between November 2002 and March 2006. Eligible patients were treated first with three cycles of induction chemotherapy (IC), paclitaxel (175 mg/m2 on day 1) and cisplatin (80 mg/m2 on day 1) followed by concomitant conventionally fractionated radiation (70 Gy in 2 Gy fractions) and cisplatin 20-mg/m2/day on days 1- 5, 22-26 and 43-47 of the radiation therapy. RESULTS: Twenty nine patients (80%) and 32 patients (89%) achieved objective response after IC and concomitant chemoradiation (CCRT) respectively. The actuarial 3 years survival was 68%, and the actuarial 3 year progression free survival (PFS) was 66%. Survival and PFS were significantly better for patients with smaller tumor volume (stage III), compared with patients with stage IV. Thirteen patients (36%) have elements of local and/or regional failure and 5 patients (14%) have an element of distant metastasis. Neutropenia (25%), mucositis (22%) and vomiting (20%) were the most severe toxicities recorded (grade 3 and 4) during IC while mucositis (36%), dermatitis (28%), anemia (14%) and vomiting (14%) were the most pronouncing toxicities (grade 3 and 4) during CCRT. CONCLUSIONS: IC followed by CCRT treatment program is feasible, tolerable and safe. This strategy improved local control and distant disease control. However combined treatment program have failed to improve survival rates over the historical result of CCRT trials.     

Cytotoxic chemotherapy before and after radiotherapy compared with radiotherapy followed by chemotherapy in the treatment of small-cell carcinoma of the bronchus: the results up to 36 months.

This report compares the results up to 36 months of two sequences of radiotherapy and chemotherapy for small-cell anaplastic carcinoma of the bronchus, of limited extent (defined below). A total of 91 patients were allocated at random to treatment with radiotherapy to the primary site followed by 10 pulses of chemotherapy using cyclophosphamide, methotrexate and CCNU (RC), and 95 to two pulses of the same chemotherapy, followed by radiotherapy, followed by 8 pulses of chemotherapy (CRC). The median survival times were 36 weeks for the RC series and 45 weeks for the CRC series but there was no statistically significant difference in survival (P = 0.9, log-rank test). At 12 months, 32 (35%) of the RC and 38 (40%) of the CRC patients were alive, at 24 months, 8 (9%) and 4 (4%), and at 36 months, 7 (8%) and 1 (1%) respectively. The patients'' general condition, grade of activity and respiratory assessment correlated significantly with survival. Of 38 patients reported to be in "excellent" condition at the start of treatment, 6 (16%) were alive at 3 years. Although there was evidence that the onset of metastases was slightly delayed in the CRC series, this difference had disappeared by 12 months.     

Prognostic significance of clinical parameters and Epstein-Barr virus infection in non-endemic undifferentiated carcinoma of nasopharyngeal type: a Serbian report

Undifferentiated carcinoma of nasopharyngeal type (UCNT) is very rare tumour in Serbia, like in most of the countries of Europe, with incidence less than 0.5 per 100,000 people per year. The aim of this study was to assess the presence of Epstein-Barr virus (EBV) in the UCNT of a non-endemic population in Serbia and identify the main clinical parameters that interfere with patients’ survival rate. This study included 102 patients with UCNT who were diagnosed between 1996 and 2003. Biopsies were analysed for EBV-encoded RNA (EBER) by in situ hybridization of tumour tissue microarray. Of 102 patients, 76 were men and 26 were women with ages ranging between 18 and 82 years (median 52.5, mean 53.0 ± 14.1). Survival rates were 80, 39 and 31% for one, three and five years, respectively. Ninety-three of 102 cases were EBER positive (92%). Factors with unfavourable prognostic values were age over 50 years at the time of diagnosis, advanced clinical stage, therapy other than chemoradiotherapy and EBER negative status. In regard to the clinical data, EBER expression in UCNT was shown to be a strong independent predictor of overall and progression-free survival. To our knowledge, the current report constitutes the largest European non-endemic series of UCNT samples from a single institution with correlation between survival and clinical parameters/EBER status.