Treatment results of 84 patients with nasopharyngeal carcinoma in childhood

Background. To evaluate the clinical characteristics, treatment regimens, survival, and late complications in patients with nasopharyngeal carcinoma. Procedure. Eighty-four patients diagnosed with nasopharyngeal carcinoma between 1972 and 2002 were retrospectively evaluated. Tumor status, lymph node involvement, metastasis, and stage were assessed according to the TNM classification. All patients were treated with radiotherapy and chemotherapy. Chemotherapeutic regimens involved cyclophosphamide from 1972 to 1982, vincristine+cyclophosphamide+epirubicine and actinomycin-D protocol from 1982 to 1999 and cisplatin+ methotrexate+5-fluorouracil with leucovorine rescue after 1999. Mean and median values were used for the demographic characteristics. Kaplan-Meier survival Curves were used for survival analysis. The patient groups were compared in terms of survival duration using a log-rank test. Results. There were 51 males and 33 females with a median age of 13 years (7-17) at diagnosis. At the time of diagnosis, 78.5% of the patients were at advanced stage (stages III and IV). Overall and event-free survival rates were 56.3% and 50.1%, respectively. Survival was inversely affected by advanced nodal status (P=0.01). The survival rates (80%) were found higher with cisplatin+methotrexate+5-fluorouracil+ leucovorine rescue regimen. The most frequent late complications after therapy were hypothyroidism (9.5%), dental caries (7.1%), and trismus (7.1%). Conclusion. The cisplatin-based regimen was the best chemotherapeutic regimen. Lesstoxic regimens with better survival rates should be investigated in patients with nasopharyngeal carcinoma. Pediatr Blood Cancer 2006;46:454-458. (c) 2005 Wiley-Liss, Inc.