Nasopharyngeal carcinoma—a retrospective review of patients less than thirty years of age: A report from childrens cancer study group

Abstract

Data from 119 patients with nasopharyngeal carcinoma who were under 30 years of age were retrospectively analyzed by the investigators of the Children's Cancer Study Group. The overall five-year survival and relapse-free survival rates from diagnosis were 51 and 36%, respectively. When the tumor was confined to the nasopharynx (1 + T2, 41 patients), the five-year survival was 75%. No significant correlation was found between survival or local recurrence and the radiation dose to the primary site. The five-year survival from relapse was 37% for 21 reirradiated patients with local and/or regional relapse compared with 11% for 45 patients with other forms of relapse. It is concluded that the optimal radiation dose for tumor eradication in young patients is now known.

Treatment results of 59 young patients with nasopharyngeal carcinoma

“…Actuarial disease-free and distant metastasis-free survivals are also significantly longer in our patients younger than 17, which draw a parallel to earlier series defining the same fact [2]. However, previously reported prognostic factors for locoregional control, such as Tstage [35], N-stage [37], total irradiation dose [37,38], and delays in radiotherapy delivery time [16,39] were not found to be significant in our series due to excellent loco-regional control.…”

“…Twenty-four percent crude rate of our institutionally treated nasopharynx patients were 30 years old, mainly owing to being a tertiary reference center. Nasopharyngeal carcinoma in the young most commonly presents as advanced locoregional disease and early stage disease is generally around 12% or fewer in previously reported series [2,3,6,10,35,36]. Along with the literature, stage I and II patients only constitute 13.6% of our cohort.…”

“…Today, the optimum dose for sustained control of NPC in children is unknown. Local control achievement was reported by doses of 50-70 Gy [35], while doses >65 Gy were also suggested to yield better local control in some of the studies [2,4,18,38]. Besides, no correlation has been shown between the EBRT dose, rate of local relapse, and survival in the literature [6,35,36].…”

Prognostic aspects in the treatment of juvenile nasopharyngeal carcinoma: a systematic review

“…Despite good local tumor control after highdose radiation therapy, treatment in many patients fails due to locoregional or systemic relapse and long-term survival is unsatisfactory. Most relapses occur within the first 2 years (median of 8 months) and more than 50 % of patients who relapse have overt distant metastases [11,18,25]. With exclusive radiotherapy, the 5-year survival rate has been reported as 20-60 % in most series of young patients affected by NPC [18,19,26,27].…”

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

“…Several publications reported that the majority of disease recurrences were either outside the margin or at the margin of the treatment portals. 11,13,27,28 Patients usually present with the undifferentiated histologic type and with advanced locoregional disease at diagnosis, and distant metastasis becomes a major obstacle in curing children with nasopharyngeal carcinoma. Clearly, there is a need for early, effective, systemic therapy.…”