Abstract: Objective To analyse the advantages and disadvantages of the -knife as the first treatment in the nasopharyngeal carcinoma. Methods From July 1995 to Oct.1998,9 patients with nasopharyngeal carcinoma firstly given -knife were treated in our department,the central dose wer 40—50Gy,and the bound dose were 18—25Gy,One week later,the patients were given neck irradiation.60—70Gy were given in positive neck and 45—50Gy were given in negative neck patients. Results 4 patients were recurred in 2 years,the second irradiation to the primary site was given,two patients were survival and two were dead.In the survival 7cases,one patient developed with bone metastases in the third year. Conclusion The patients with nasopharyngeal carcinoma firstly given -knife have a high local recurrence rate in short time,and their effects are not superior to the routine radiotherapy.