Cumulative 5 years survival following radiotherapy for carcinoma of the nasopharynx does not exceed 30 divided by 35%. Better survival rates are reported in patients with primary lesion of limited extent (T1) or without neck lymph node involvement (N0): 5 years survival 50 divided by 60%. Reports from the most recent series and a review of 159 cases treated at National Cancer Institute of Milano indicate the prognostic significance of the histological type. The 5 years survival rate for "well differentiated carcinoma" ranges from 10 to 34%, in comparison with 25 divided by 50% for the "undifferentiated" type. Local recurrence and invasion of the base of the skull are seen more frequently in the "well differentiated" group while the "undifferentiated carcinoma" shows a stronger tendency to distant metastases (30 divided 35%). On the base of these data a more selected therapeutic approach is suggested.