Nasopharyngeal cancer is the malignant tumor of the head and neck with the highest incidence in China, especially in the southern region of China. Combination therapy (including chemotherapy and targeted drug therapy) based on radiation therapy is the fundamental treatment mode of nasopharyngeal cancer. Why can’t nasopharyngeal cancer be surgically removed? There are several reasons: 1. Special anatomical location of nasopharynx. The nasopharyngeal cavity is located at the posterior end of the nasal cavity, below the skull base, at the front edge of the vertebral body, and downward to the oropharynx. It is a size of about 3 * 3 * 3 cm, nearly square hexahedron, divided into the top, top posterior wall, posterior wall, both sides of the wall, the front wall and the bottom wall of six walls. Although he is small in size, he is in a major traffic channel of blood vessels and nerves between the brain and the neck and torso. Due to the special anatomical location, nasopharyngeal malignant tumor may grow in all directions, for example, upward growth may invade the skull base bone, even into the skull, cavernous sinus, orbital tip and, to both sides may invade the masticatory muscle, cervical artery and vein, posterior group of cranial nerves; downward may reach the oropharynx, backward may invade the slope bone and occipital bone, cervical vertebrae, etc. Therefore, it is necessary to investigate these blood vessels and cranial nerves before they are detected. Therefore, it is difficult to completely resect the tumor in the complex area of blood vessels, cranial nerves, muscles and skull base bones, while preserving the normal tissue and organ functions. Therefore, the anatomical complexity determines that nasopharyngeal cancer cannot be cured by surgery. 2. The skull base of the maxillofacial region is one of the most complex structures in our body, and this small space contains the complex receptors of the five senses of our body, which are reported to our brain command through twelve pairs of cranial nerves. Therefore, damage to any of the nerves, blood vessels, receptors, and effectors can cause considerable loss of quality of life, such as vision, hearing, smell, taste, skin sensation, and so on. This point also determines that we dare not easily make a big move in this complex area. 3. The metastasis rate of cervical lymph nodes in nasopharyngeal cancer is extremely high, and the treatment of double cervical lymph nodes is also a difficult point of surgery. Some nasopharyngeal cancers have liver metastasis, lung metastasis and bone metastasis when they are diagnosed, and they cannot be treated by surgery. 4.Most of the nasopharyngeal carcinomas are low-differentiated squamous carcinomas, which are more sensitive to radiation therapy. Surrounding normal tissues tolerate radiation better and have good treatment gain ratio. The effect of radiotherapy for nasopharyngeal cancer is very good. At present, major domestic cancer centers report that the 5-year survival rate of intensity-modulated radiotherapy is about 80% and the 5-year local control rate is about 90%. In conclusion, surgery is not the first choice for nasopharyngeal cancer, and radiotherapy is the only curative means for nasopharyngeal cancer!