Nasopharyngeal carcinoma in children and adolescents: A single center study

Abstract

Background: Nasopharyngeal carcinoma (NPC) is very rare in children and adolescents. The aim of this study was to evaluate clinical characteristics and treatment outcomes of pediatric NPC. Methods: Medical records of 9 patients treated for NPC at the Seoul National University Childrens Hospital between 1988 and 2012 were analyzed retrospectively. Results: The median age at diagnosis was 11 years (range, 9–13 years). One patient had stage II disease, 3 had stage III disease, and 5 had stage IV disease. The histologic subtypes were undifferentiated carcinoma and squamous cell carcinoma in 7 and 2 patients, respectively. All patients were initially treated with cisplatin (100 mg/m2 intravenous [IV] every 4 weeks for 4–6 months), bleomycin (15 unit/m2 IV every 1 week × 7), and fluorouracil (1,000 mg/m2 IV every 4 weeks for 1 year). Eight patients received radiotherapy with doses of 45–59.4 Gy at the primary site and neck nodes. Seven patients (77.8%) achieved complete remission, 1 (11.1%) achieved partial remission, and 1 (11.1%) showed disease progression. Six patients developed fluorouracil-related neurotoxicity

the regimen was changed to cisplatin, epirubicin, and bleomycinin five of the 6 patients. One patient died of progressive disease without responding to treatment. Treatment-related mortality occurred in 1 patient owing to septic shock. Secondary osteosarcoma developed in 1 patient 6 years after treatment. The overall survival was 77.8%, with a median follow-up of 40.8 months (range, 4.5–287.6 months). Conclusion: Children and adolescents with advanced NPC treated with combined chemotherapy and radiotherapy have a good survival rate.