Locoregionally advanced nasopharyngeal carcinoma in childhood and adolescence: Analysis of 95 patients treated with combined chemotherapy and intensity‐modulated radiotherapy

Abstract

Neoadjuvant chemotherapy followed by IMRT with or without concurrent/adjuvant chemotherapy produced a superb treatment outcome in children and adolescents with stage III to IVB disease. Distant metastasis was the main failure. More effective treatment strategies are urgently needed to further improve the long-term survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E665-E672, 2016.

A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma

“…A prospective, randomized study by Peng et al compared the outcomes and toxicities of IMRT vs. 2D-CRT for the treatment of NPC, and the result showed that better local recurrence-free survival and a lower incidence of toxicities can be achieved in the IMRT group for late-stage NPC patients (Peng et al 2012). In the current study, the NPC failure pattern was not altered by IMRT, and distant metastasis remained the major pattern of failure in paediatric and adolescent NPC, a result similar to the findings of other reports (Tao et al 2013; Guo et al 2015). The relatively short time to systemic failure in the absence of locoregional failure might suggest that subclinical metastasis that likely existed at first treatment required early systemic treatment.…”

“…With better outcomes and longer survival, the prevention of radiation-induced complications becomes more important, and several studies have demonstrated quality of life advantages with IMRT in children with NPC (Tao et al 2013; Guo et al 2015). Laskar et al (2008) compared 2D-CRT with IMRT in 36 cases of paediatric and adolescent NPC.…”

“…According to experiences with the use of IMRT for adults with NPC (Peng et al 2012; Mao et al 2015), it is expected that implementation of IMRT for children and adolescent NPC would also translate into an improved outcome with reduced treatment-related toxicities. However, studies that examine the application of IMRT in children and adolescent NPC are rare (Laskar et al 2008; Guo et al 2015), and no evidence has demonstrated significant advantages of IMRT compared with 2D-CRT regarding the survival rate and late treatment-related toxicities. The purpose of this retrospective study is to assess whether the use of IMRT is associated with improved clinical outcomes and reduced treatment-related toxicities compared with 2D-CRT in children and adolescent NPC.…”

Clinical Implications of Plasma Epstein–Barr Virus DNA in Children and Adolescent Nasopharyngeal Carcinoma Patients Receiving Intensity-Modulated Radiotherapy

“…In the current study, IMRT has provided excellent locoregional control in children and adolescent NPC patients with LRRFS of 95.2%. Nevertheless, the NPC failure pattern was not altered by IMRT, and distant metastasis remained the major pattern of failure, a result similar to the findings of other reports (5,35,36). We observed that a level of pretreatment EBV DNA >40,000 copies/mL was highly statistically significantly associated with the poorer DMFS and DFS.…”

Nasopharyngeal Carcınoma in Chıldren and Adolescents; Experıence of EGE Unıversıty from Turkey

“…However, studies that examined the use of IMRT in pediatric and adolescent NPC patients are limited [12,13]. In a recent study of locoregionally advanced NPC, 95 childhood and adolescence patients received combined CT (CDDP, Paclitaxel, Gemcitabine) and IMRT [14]. All the patients had been treated with neoadjuvant chemotherapy before IMRT with or without concurrent chemotherapy/adjuvant chemotherapy.…”