Nasopharyngeal carcinoma in children and adolescents- results of a multicenter study (NPC-91-GPOH)

Mertens, Rolf; Granzen, Bernd; Gademann, G.; Hess, Ch.

doi:10.1055/s-2005-869161

Cited by 34 publications

(81 citation statements)

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“…The primary objective is EFS, which we defined as the time from diagnosis to the first progression at any site, relapse, or death from any cause (this was referred to as DFS in our previous article 11 but was defined in the same way). Patients who remained alive without disease progression or relapse were censored at the date of their last follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Fiblaferon is no longer available; thus, since 2010, all patients have received Rebif. Like in the study NPC-1991-GPOH, 11 patients received Fiblaferon at a dose of 100,000 IU/kg intravenously over 30 minutes 3 days per week, usually Monday, Wednesday, and Friday, and the maximum single dose was 5 million IU for patients with a body weight >50 kg. This regimen originally was derived from dose-finding studies by Treuner et al 26 Patients received Rebif at the same dose and regimen subcutaneously with a maximum single dose of 6 million IU.…”

Section: Interferon Treatmentmentioning

confidence: 99%

“…After a median follow-up of 48 months, an OS rate of 95% and an EFS rate of 91% were achieved, and the level of toxicity was acceptable. 11 Encouraged by these promising results, the next prospective trial, NPC-2003-GPOH, was started in 2003. Compared with the NPC-91-GPOH study, chemotherapy was reduced in NPC-2003-GPOH by omitting methotrexate in the induction chemotherapy courses with the intention of reducing the rate of severe mucositis.…”

Section: Introductionmentioning

confidence: 99%

“…1,8,9 Children and adolescents usually present with advanced stage disease. [10][11][12] In recent years, most pediatric patients with NPC have received a combination of chemotherapy and radiotherapy with various regimens worldwide, usually containing cisplatin and often 5-fluorouracil. Reported survival rates vary between 55% and 90% for overall survival (OS) and between 60.6% and 77% for disease-free survival (DFS) and event-free survival (EFS).…”

Section: Introductionmentioning

confidence: 99%

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Multimodal treatment, including interferon beta, of nasopharyngeal carcinoma in children and young adults

Buehrlen

Zwaan

Granzen

et al. 2012

Cancer

109

150

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BACKGROUND:The authors report preliminary results from a prospective multicenter study (Nasopharyngeal Carcinoma [NPC] 2003 German Society of Pediatric Oncology and Hematology/German Children's Oncology Group [NPC‐2003‐GPOH/DCOG]).METHODS:From 2003 to 2010, 45 patients (ages 8‐20 years), including 1 patient with stage II NPC and 44 patients with stage III/IV NPC, were recruited to the study. The patient with stage II disease received radiotherapy (59.4 grays [Gy]). The patients with stage III/IV disease received 3 courses of neoadjuvant chemotherapy with cisplatin, 5‐fluorouracil, and folinic acid. The cumulative irradiation dose was 54 Gy in 5 patients, who achieved complete remission after neoadjuvant chemotherapy, and 59.4 Gy in the remaining 40 patients. All patients received concomitant cisplatin during the first week and last week of irradiation. After irradiation, all patients received interferon beta for 6 months. Tumor response was evaluated by magnetic resonance imaging studies and positron emission tomography scans.RESULTS:After the completion of treatment, 43 of 45 patients were in complete remission. In 2 patients, only a partial response was achieved, followed by distant metastases (1 patient) or local progression and distant metastases (1 patient), 6 months and 10 months after diagnosis, respectively. Another patient developed a solitary pelvic bone metastasis 21 months after diagnosis. After a median follow‐up of 30 months (range, 6‐95 months), the event‐free survival rate was 92.4%, and the overall survival was 97.1%. Acute toxicity consisted mainly of leucopenia, mucositis, and nausea; and late toxicity consisted of hearing loss and hypothyroidism.CONCLUSIONS:Combined therapy with neoadjuvant chemotherapy, radiochemotherapy, and interferon beta was well tolerated and resulted in a very good outcome that was superior to the outcomes of published results from all other pediatric NPC study groups. Cancer 2012. © 2012 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Section: Interferon Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multimodal treatment, including interferon beta, of nasopharyngeal carcinoma in children and young adults

Buehrlen

Zwaan

Granzen

et al. 2012

Cancer

109

150

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“…Paediatric NPC is biologically more aggressive (WHO grade III) and most often presents as an advanced locoregional disease. Treatment of paediatric NPC has seen a huge wave of change: initially in the early 1990 irradiation alone was considered curative [2], combination of chemotherapy and radiotherapy became the standard of care in the late 1990 and since the dawn of the new millennium chemo-radiotherapy followed by adjuvant immunotherapy using beta interferon has become the benchmark treatment [3,4].…”

Section: Introductionmentioning

confidence: 99%

Paediatric Nasopharyngeal Carcinoma: An 8-Year Study from a Tertiary Care Cancer Centre in South India

Guruprasad

Tanvir

Rohan

et al. 2013

Indian J Otolaryngol Head Neck Surg

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Nasopharyngeal carcinoma (NPC) accounts for less than 1 % of all paediatric cancers. Advances in imaging, radiation delivery, chemotherapy and improvement in multidisciplinary care have resulted in drastic changes in the outcome of this disease. Since NPC is extremely rare in paediatric population and there is paucity of data in Indian patients, we conducted the present study to analyze the outcome of paediatric NPC. Eighteen patients aged 18 years or less, who had pathologically proven diagnosis of NPC and had received treatment at our institute from 2003 to 2010 was included for analysis. These patients were treated with radiotherapy and chemotherapy. Event free survival, local and systemic relapse and progression were analysed. These outcomes were correlated with age, radiation dose and the stage of disease. Majority of patients presented with advanced stage and poor histological grade (94.4 % had WHO Type III disease). The median follow up was 38 months (range 3-91 months). The estimated event free survival at a follow up of 5 years was 64.28 %. Distant metastasis at presentation and lower radiation dose were predictive of poor outcome. Paediatric NPC usually presents in an advanced stage. Our results are comparable to studies which have used only chemoradiotherapy, are far inferior to studies which have used chemoradiotherapy and adjuvant immunotherapy. Larger prospective studies are required to define the role of adjuvant immunotherapy, the optimum dose and schedule of chemoradiotherapy and role of new agents like cetuximab in Indian paediatric patients.

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Association of Treatment Advances With Survival Rates in Pediatric Patients With Nasopharyngeal Carcinoma in China, 1989-2020

et al. 2022

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IMPORTANCE Advanced techniques and treatment methods have been found to be associated with improved survival rates in adults with nasopharyngeal carcinoma (NPC); however, not much is known about associations in pediatric patients. OBJECTIVETo investigate whether advanced imaging diagnosis, radiotherapy (RT) technology, and treatment modality are associated with survival in pediatric patients with NPC. DESIGN, SETTING, AND PARTICIPANTS In this retrospective cohort study, 810 pediatric patients ages 21 years and younger with nonmetastatic NPC diagnosed from 1989 to 2020 at a single cancer center in China were included. Data were analyzed from April through December 2021.EXPOSURES Patients were divided into 3 groups by initial treatment date (ie, 1989-2002, 2003-2011, and 2012-2020). Associations between advances in technology and treatment and survival were investigated. Comparisons of advances vs older technology and treatments included those in imaging diagnosis (magnetic resonance imaging [MRI] vs computed tomography [CT] and positron emission tomography [PET]-CT with MRI vs CT), radiotherapy (RT) techniques (intensity-modulated RT [IMRT] or TomoTherapy [TOMO] vs 2-dimensional conventional radiotherapy [2D-CRT] or 3-dimensional conventional radiotherapy [3D-CRT]), and treatment methods (concurrent chemoradiotherapy [CCRT] vs RT alone, induction chemotherapy [IC] with CCRT vs RT alone, and CCRT or RT with adjuvant chemotherapy [AC] vs RT alone). MAIN OUTCOMES AND MEASURES The primary end point was progression-free survival (PFS).Secondary end points were overall survival (OS), distant metastasis-free survival, and locoregional recurrence-free survival. Cox and competing-risks regression were used to estimate hazard ratios (HRs) and 95% CIs for associations between variables and survival. RESULTS Among 810 pediatric patients with NPC, the median (IQR) age was 18 (15-20) years, and there were 577 [71.2%] male patients. This included 122 patients in the 1989 to 2002 period, 212 patients in the 2003 to 2011 period, and 476 patients in the 2012 to 2020 period. The 5-year PFS and

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Nasopharyngeal carcinoma in children and adolescents- results of a multicenter study (NPC-91-GPOH)

Cited by 34 publications

References 0 publications

Multimodal treatment, including interferon beta, of nasopharyngeal carcinoma in children and young adults

Multimodal treatment, including interferon beta, of nasopharyngeal carcinoma in children and young adults

Paediatric Nasopharyngeal Carcinoma: An 8-Year Study from a Tertiary Care Cancer Centre in South India

Association of Treatment Advances With Survival Rates in Pediatric Patients With Nasopharyngeal Carcinoma in China, 1989-2020

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