Combined radiotherapy and chemotherapy in stage T3 and T4 nasopharyngeal carcinoma in children.

Abstract

Twelve children younger than 16 years affected by undifferentiated nasopharyngeal carcinoma (NPC) with advanced primary tumor (T3, T4) were treated with chemotherapy consisting of Adriamycin (ADM [doxorubicin; Adria Laboratories, Columbus, OH]), vincristine (VCR), and cyclophosphamide (CYC), and radiotherapy. Preradiation chemotherapy produced partial responses in eight of ten evaluable patients. Eleven of 12 patients achieved a complete response following radiotherapy. The actuarial 3-year continuous relapse-free survival (CRFS) was 75%. This represents a significant improvement when compared with the 8% rate obtained in a previous series of patients treated with radiotherapy either with or without adjuvant CYC.

High‐dose‐rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood

“…29 -34 However, more recent publications have shown reasonable local and distant disease control rates in adults and children. 24,25,[35][36][37][38][39][40][41][42][43][44] There are no randomized trials in nasopharyngeal carcinoma in childhood; however, it is interesting to consider three prospective trials: Gasparini et al 37 treated 12 children with advanced nasopharyngeal carcinoma with preradiation chemotherapy and achieved a 75% actuarial 3-year continuous recurrence-free survival rate. Ghim et al 42 reported on a 20-year experience treating children with nasopharyngeal carcinoma.…”

Nasopharyngeal carcinoma in childhood and adolescence

“…This last schedule was used following the experience reported by Gasparini et al as first-line therapy. 6 A supplementary irradiation was administered to the involved areas (20 -30 Gy) in each case. One patient died of disease 10 months after recurrence.…”

“…In recent years, several reports in children and adults by using a combined therapeutic strategy seem to support this statement. 3,[5][6][7][8][9][17][18][19][20][21] There is a small reported evidence of NPC in children. However, therapy strategies with a combined modality showed that very good long term disease free survival might be obtained.…”

“…But in recent years, chemotherapy combined with radiotherapy has been yielding better results, with significant disease free survival improvement in children and young adults in whom the undifferentiated variant is predominant. 3,[5][6][7][8][9] The purpose of this report was to analyze features at onset, treatment results, and outcome of children and adolescents with NPC followed in our hospital since 1988.…”

“…3,5,6,8 Most of pediatric cases are undifferentiated (WHO Grade 3) and related to the EBV. 4,22 The relation of undifferentiated NPC with EBV has led Mertens et al to design a treatment protocol with a prolonged therapy of recombinant ␤-interferon during 6 months.…”