**7. Tumor volume in NPC: A new prognostic factor?**

Instead of the classical T,N,Age,Sex and histologic type, prognostic value of Primary Tumor Volume(PTV), measured by CT-scan have been explored for NPC in 112 patients with Stage I-IVB NPC treated by IMRT (Chen et al, 2011). The mean PTV was 33.9 ± 28.7 ml and classified from V1 to V4 (from 15.65 to 50,5ml). It impacted on 5-year overall survival who varies from 88.5, 83.3, 82.4 to 54.5% for V1 to V4 from, showing that V1-V4 are clearly separated from V4 (p = 0.014). Cox proportional hazards regression model analysis showed that a PTV >50 ml was an independent risk factor for radiotherapy (risk ratio = 3.485, P = 0.025). In 56 Turkish patients with locally advanced NPC, PTV have been calculated by measuring tumor diameters by CT and MR film hardcopies computed as an ellipsoid (V=4/3·π·d1·d2·d3) to obtain the diameter-based volume(Sarisahin et al, 2011). They reported in the monovariate analysis, that primary tumor volume have a significant predictive value on DFS and DMFS, if tumor volume < 20ml, DFS was 60% vs 0% if > 60ml(p=0.007). The residual tumor volume (RTV) at first control after treatment was also

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