Radiation and chemotherapy combination for nasopharyngeal carcinoma in children: Radiotherapy dose adaptation after chemotherapy response to minimize late effects

Orbach, Daniel; Brisse, H.; Helfre, Sylvie; Klijanienko, Jerzy; Bours, D.; Mosseri, Véronique; Rodriguez, José

doi:10.1002/pbc.21372

Cited by 58 publications

(64 citation statements)

References 18 publications

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“…Although there are few randomised studies in children, recent publications have reported increased response rates and disease-free survival with chemotherapy compared with historical controls [11,23,28,29]. An interesting approach aiming to limit the radiotherapy dose to the cervical lymph nodes (and, thus, contain the related toxicity) has recently been reported by the Curie Institute in Paris, where children who responded well to neoadjuvant chemotherapy (tumor volume reduction [90 %) received lower doses of radiotherapy (\50 Gy) [30].…”

Section: Discussionmentioning

confidence: 96%

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

Gioacchini

Tulli

Kaleci

et al. 2016

Eur Arch Otorhinolaryngol

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To systematically review and discuss the published data about treatments and outcomes for children and adolescents affected by nasopharyngeal carcinoma. In April 2015, an appropriate string was run on PubMed to retrieve all relevant articles. A cross-check was performed by two of the authors on abstracts and full-text articles found using the selected inclusion and exclusion criteria. A meta-analysis concerning the rate of reported disease-free survival and overall survival was performed. Fifteen studies were identified comprising a total of 865 subjects affected by nasopharyngeal carcinoma. According to the American Joint Committee for Cancer Staging system, the majority of tumors were classified as Stage IV (57.3 %). All included patients underwent radiotherapy, while 687 (79.4 %) received also some regimen of chemotherapy. On the basis of our statistical analysis, the mean (95 % CI) rate of disease-free survival was 66 % (95 % CI 56-76). The mean (95 % CI) rate of the overall survival resulted 68 % (95 % CI 58-78). On the basis of our analysis, it may be affirmed that the prognosis of juvenile nasopharyngeal carcinoma is still unsatisfactory. New reports on homogeneous populations are needed to better define the most influencing prognostic factors and to evaluate the introduction of possible alternative therapeutic protocols.

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Section: Discussionmentioning

confidence: 96%

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

Gioacchini

Tulli

Kaleci

et al. 2016

Eur Arch Otorhinolaryngol

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“…Nasopharyngeal carcinoma (NPC) is extremely rare in children1–3 with overall survival between 50% and 77% 2–4. Combined chemoradiotherapy constitutes the treatment of choice for this malignancy, with promising results,3–5 which was also the case in patient A.…”

Section: Discussionmentioning

confidence: 99%

“…Nasopharyngeal carcinoma (NPC) is scarcely reported in children,1–3 more often of undifferentiated type, while combined chemoradiotherapy constitutes the treatment of choice for this malignancy with promising results 3–5. Overall survival between 50% and 77% is reported 2–4.…”

Section: Introductionmentioning

confidence: 99%

Long-term radiotherapy related complications in children with head and neck cancer: Another era for pediatric oncologic pathology

Eleftheriadis¹,

Papaloukas²,

Eleftheriadis³

et al. 2009

IJGM

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Long-term radiotherapy-related complications in children with head and neck cancer have been frequently reported, especially facial growth disorders and dental abnormalities. We report on two male children (8 and 14 years old) with head and neck cancer, who were successfully treated with chemoradiotherapy and presented with growth deficiency of middle face and mandible hypoplasia, eight years and one year later, respectively. These severe growth complications attributed to chemoradiotherapy, while the patients survived primary malignancy. Patient age at irradiation was significantly correlated with the severity of disorders. We consider late sequelae in children with head and neck cancer due to chemoradiotherapy another era for pediatric oncologic pathology for prevention, if possible, or to manage them efficiently.

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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%.…”

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%

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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Radiation and chemotherapy combination for nasopharyngeal carcinoma in children: Radiotherapy dose adaptation after chemotherapy response to minimize late effects

Cited by 58 publications

References 18 publications

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

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

Long-term radiotherapy related complications in children with head and neck cancer: Another era for pediatric oncologic pathology

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

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