Pediatric and Young Adult Nasopharyngeal Carcinoma Patients Treated With Preradiation Cisplatin and Docetaxel Chemotherapy

Varan, Ali; Özyar, Enis; Çorapçıoğlu, Funda; Köksal, Yavuz; Aydın, Burça; Yazıcı, Nalan; Akyüz, Canan; Büyükpamukçu, Münevver

doi:10.1016/j.ijrobp.2008.05.028

Cited by 22 publications

(14 citation statements)

References 28 publications

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“…10,[13][14][15][16][17][18][19][20][21][22] The results vary between 55% and 87% for OS and 60.6% and 77% for EFS or DFS, and the median length of observation for these cohorts was between 3.5 years and 15 years. Varan et al reported 10 retrospectively analyzed patients who received the same regimen (4 cycles of docetaxel/cisplatin plus irradiation 59.4 Gy) 23 : After a median observation of 2 years, the OS rate was 90%, and the EFS rate was 70%. There are 2 reported prospective studies about NPC treatment in children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

“…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). 10,[12][13][14][15][16][17][18][19][20][21][22][23] From 1992 to 2002, the first prospective NPC trial by the German Society of Pediatric Oncology and Hematology (NPC-91-GPOH), in which chemotherapy, radiotherapy, and interferon beta (IFN-b) were combined, was conducted within the GPOH. 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.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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: Introductionmentioning

confidence: 99%

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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“…Varan et al [24] first evaluated the effectiveness of neoadjuvant cisplatin and docetaxel plus radiotherapy in pediatric and adolescent NPC. The 2-year overall survival rate was 90% and the event-free survival rate was 70%.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma

Chang¹,

Liu²,

TANG³

et al. 2013

Chin J Cancer

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The application of simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in pediatric and adolescent nasopharyngeal carcinoma (NPC) is underevaluated. This study aimed to evaluate long-term outcome and late toxicities in pediatric and adolescent NPC after SIB-IMRT combined with chemotherapy. Thirty-four patients (aged 8–20 years) with histologically proven, non-disseminated NPC treated with SIB-IMRT were enrolled in this retrospective study. The disease stage distribution was as follows: stage I, 1 (2.9%); stage III, 14 (41.2%); and stage IV, 19 (55.9%). All patients underwent SIB-IMRT and 30 patients also underwent cisplatin-based chemotherapy. The prescribed dose of IMRT was 64–68 Gy in 29–31 fractions to the nasopharyngeal gross target volume. Within the median follow-up of 52 months (range, 9–111 months), 1 patient (2.9%) experienced local recurrence and 4 (11.8%) developed distant metastasis (to the lung in 3 cases and to multiple organs in 1 case). Four patients (11.8%) died due to recurrence or metastasis. The 5-year locoregional relapse–free survival, distant metastasis–free survival, disease-free survival, and overall survival rates were 97.1%, 88.2%, 85.3%, and 88.2%, respectively. The most common acute toxicities were grades 3–4 hematologic toxicities and stomatitis. Of the 24 patients who survived for more than 2 years, 16 (66.7%) and 15 (62.5%) developed grades 1–2 xerostomia and ototoxicity, respectively. Two patients (8.3%) developed grade 3 ototoxicity; no grade 4 toxicities were observed. SIB-IMRT combined with chemotherapy achieves excellent long-term locoregional control in pediatric and adolescent NPC, with mild incidence of late toxicities. Distant metastasis is the predominant mode of failure.

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“…4 Recently, most pediatric patients have received a combination of radiotherapy and chemotherapy, which results in the 5-year OS rates varying from 55% to 90%, and the DFS rates varying from 60.6% to 77.0%. 14,16,23–30 In this study, the 5-year OS and DFS rates of the whole series were 79.3% and 72.9%, respectively. However, it is surprising that we did not observe any difference in the 5-year OS and 5-year LRCS rates for patients with stage III, IVa, and IVb diseases, whether they had received concurrent chemotherapy or not, but a large impact on the 5-year DFS and MFS rates was observed.…”

Section: Discussionmentioning

confidence: 53%

Long-Term Outcomes of Nasopharyngeal Carcinoma in 148 Children and Adolescents

et al. 2016

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The aim of this study was to investigate the survival and long-term morbidities of nasopharyngeal carcinoma (NPC) in children and adolescents.We retrospectively reviewed children and adolescents with NPC treated at Sun Yat-sen University Cancer Center from February 1991 to October 2010, where the prognostic factors and long-term effects of therapy were analyzed.A total of 148 patients were identified. The median age was 15 years old (range, 5–18 years) and the male to female ratio was 3.6:1. Most of the tumor histopathology was undifferentiated nonkeratinizing carcinoma (97.3%). The number of patients staged with IVa, IVb, IVc, III, and II were 45 (30.4%), 12 (8.1%), 5 (3.4%), 70 (47.3%), and 16 (10.8%), respectively. For the whole series with a median follow-up of 81 months (range, 6–282 months), the 5-year overall survival (OS) and disease-free survival (DFS) ratios were 79.3% and 69.7%, respectively. We observed significant differences in the 5-year OS (81.1% vs 25.0%, P = 0.002) and the DFS rates (72.2% vs 0.0%, P = 0.000) between patients with stage II to IVb disease and stage IVc disease. For patients with stage II, III, IVa, and IVb disease, we found a high radiation dose (dose > 66 Gy to the primary lesion) would not significantly improve the survival compared to the sub-high radiation dose group (dose = 60–66 Gy to the primary lesion), even considering the type of radiation therapy technologies. However, the incidences of sequelae (grades I–IV) in patients with high radiation dose were apparently higher than those in patients with low radiation dose.Considering the late sequelae, a dose of 60 to 66 Gy to the primary lesions seems to be enough for children and adolescents with NPC.

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Pediatric and Young Adult Nasopharyngeal Carcinoma Patients Treated With Preradiation Cisplatin and Docetaxel Chemotherapy

Cited by 22 publications

References 28 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

Long-term outcome and late toxicities of simultaneous integrated boost-intensity modulated radiotherapy in pediatric and adolescent nasopharyngeal carcinoma

Long-Term Outcomes of Nasopharyngeal Carcinoma in 148 Children and Adolescents

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