Nasopharyngeal carcinoma (NPC) is rare in most countries,especially in Europe and North America (incidence rate below 1/100 000 people per year). However, it has a high incidence in several southern areas in China, especially in the Cantonese region, including Guangzhou city, where the incidence rate is approximately 30-80/100 000 people per year.1 In the high incidence areas, more than 95% NPCs are poorly differentiated (WHO types 2 and 3), which are sensitive to radiotherapy and chemotherapy. Besides its special epidemiological and pathological characteristics, NPC differs from other head and neck cancers in terms of its unique clinical development features. The advanced NPCs can be divided into three clinical types:2 (a) cranial type (A or ascending type) is characterized by direct extension of the tumor toward the base of skull with involvement of the cranial nerves Ⅰ, Ⅲ, Ⅳ, Ⅴ1 and Ⅵ and/or destruction of the bone, but without cervical lymphadenopathy. About 12.4% patients belonged to this type; (b) generalized cervical lymphadenopathy type (D or descending type) has the special feature of extensive metastasis in the cervical lymph nodes on one or both sides with a large mass of 8 cm×8 cm, yet without affecting the cranial nerves (42.2%); (c) mixed type (AD or ascending-descending type) shows the features of both the above 2 types, but cervical lymphadenopathy usually remains localized for a long time and the size of the mass rarely reaches 8 cm×8 cm (30.0%). A representative example of type A and type D patients is shown in Fig. 1. Different clinical subsets have different biological behaviors, different treatment outcomes, and deserve different therapeutic plans. Therefore, defining NPC clinical types is useful for the individualized therapeutic planning.