Treatment of nasopharyngeal carcinoma in children and adolescents

Mertens, Rolf; Granzen, Bernd; Lassay, Lisa; Bucsky, Peter; Hündgen, Manfred; Stetter, G; Heimann, G.; Weiß, Claudia; Hess, Clemens F.; Gademann, G.

doi:10.1002/cncr.21258

Cited by 102 publications

(65 citation statements)

References 63 publications

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“…The relatively short time to systemic failure in the absence of locoregional failure might suggest that subclinical metastasis that likely existed at first treatment required early systemic treatment. Two prospective multicentre studies, NPC-91-GPOH (Mertens et al 2005) and NPC-2003-GPOH/DCOG (Buehrlen et al 2012), demonstrated favourable results for multimodal treatment (neoadjuvant chemotherapy, and radiotherapy followed by interferon-β) in patients with paediatric and adolescent NPC. After a median follow-up time of 30 months and 48 months, the overall survival and event-free survival rates were 95–97% and 91–92.4%, respectively.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma

Qiu

Peng

Haiqun

et al. 2017

J Cancer Res Clin Oncol

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PurposeTo compare the clinical outcomes and toxicities of two-dimensional conventional radiotherapy (2D-CRT) and intensity-modulated radiotherapy (IMRT) for the treatment of children and adolescent nasopharyngeal carcinoma (NPC).MethodsA total of 176 children with non-metastatic NPC treated at Sun Yat-sen University Cancer Center between October 2003 and September 2013 were included in this study. Of the 176 patients, 74 received 2D-CRT and 102 were treated with IMRT. The clinical outcomes and acute and late toxicities were determined and compared.ResultsThe IMRT group achieved significantly higher overall survival (OS) (90.4% vs. 76.1% at 5 year, P = 0.007) and disease-free survival (DFS) (85.7% vs. 71.2%, P = 0.029) mainly due to an improvement in locoregional relapse-free survival (LRRFS) (97.9 vs. 88.3%, P = 0.049). After stratification by disease stage, IMRT provided significant benefits for patients with stage III–IV disease in terms of OS, LRRFS and DFS. Multivariate analyses indicated that the treatment group (2D-CRT vs. IMRT) was a prognostic factor for OS, LRRFS and DFS. A significant reduction in Grade 2–4 xerostomia (52.7 vs. 34.3%, P = 0.015) and hearing loss (40.5 vs. 22.5%, P = 0.010) was observed in patients treated by IMRT.ConclusionIMRT provides better locoregional relapse-free survival and overall survival, especially in late-stage children and adolescent NPC patients, and is associated with a lower incidence of Grade 2–4 xerostomia as well as hearing loss compared with 2D-CRT. Distant metastasis remains a challenge in the treatment of children and adolescent NPC.

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Section: Discussionmentioning

confidence: 99%

A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma

Qiu

Peng

Haiqun

et al. 2017

J Cancer Res Clin Oncol

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“…Young patients have more advanced disease at diagnosis and distant metastases are more frequently seen [4]–[9]. This might be caused by the undifferentiated state of the tumor, which is prone to develop distant metastasis [4], [6]–[7]. Another hypothesis is the late recognition of complaints belonging to NPC in young patients, since early symptoms of NPC are non-specific and can look like ordinary upper airway infections, which are common in children.…”

Section: Introductionmentioning

confidence: 99%

“…Several retrospective trials have proven the benefit of additional chemotherapy in juveniles [4], [9]–[12]. Five-year disease-free survival varies between 45–77% and 5-year overall survival is 52–77% [5], [7]–[12]. Recently, Buehren et al published more promising results by adding adjuvant interferon beta after standard (chemo-) radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Current Status of Cancer Care for Young Patients with Nasopharyngeal Carcinoma in Jakarta, Indonesia

et al. 2014

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BackgroundNasopharyngeal carcinoma (NPC) is endemic in Indonesia and 20% of the patients are diagnosed before the age of 31. This study evaluates presentation and treatment outcome of young patients in Jakarta, in a tertiary referral centre.MethodsForty-nine patients under the age of 31, diagnosed with NPC between July 2004 and January 2007, were evaluated. Baseline data included histological type, stage of disease and presenting symptoms. We intended to follow all patients after diagnosis to reveal treatment outcome and overall survival (OS).ResultsAll but two patients had advanced stage disease (94%), 7 (14%) had distant metastasis. The median interval between start of complaints and diagnosis was 9 months. Forty-two patients were planned for curative intent treatment. Eleven patients (26%) never started treatment, 2 patients did not complete treatment and 3 patients did not return after finishing treatment. Four patients died before radiation could start. Three patients died within 4 months after treatment. Nine patients (21%) had a complete response. Due to the high number of patients who were lost to follow-up (LFU), OS was analyzed as follows: a best-case (patients censored at last contact) and a worst-case scenario (assuming that patients who did not finish treatment or had disease at last contact would have died). The 2-year OS for patients without distant metastases was 39–71%.ConclusionTreatment outcome for young patients with NPC in this institute was poor. Improvement can be achieved when NPC is diagnosed at an earlier stage and when there is better treatment compliance.

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“…As a result, the five-year survival rate of NPC patients is between 10 and 40%3. Although many clinical trials have shown that patients receiving pre-radiation chemotherapy with methotrexate (MTX), cisplatin and 5-fluorouracil could significantly improve the five-year survival rate of metastatic NPC patients45, a considerable number of NPC patients develop drug-resistance and succumb to NPC as a result of disease progression. Therefore, new and effective treatments for NPC patients are urgently needed.…”

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confidence: 99%

Mechanistic Study of Tetrahydrofuran- acetogenins In Triggering Endoplasmic Reticulum Stress Response-apotoposis in Human Nasopharyngeal Carcinoma

Juang

Chiang

Liang

et al. 2016

Sci Rep

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For past three decades, numerous studies have elucidated the antiproliferative effects of acetogenins in hopes of developing a new class of clinical anticancer agents. However, clear and definitive action mechanisms of acetogenins were less clarified. In the present study, three tetrahydrofuran (THF)-containing acetogenins were found to have potent and selective antiproliferative activity against human nasopharyngeal carcinoma (NPC) cell lines and their methotrexate-resistant counterparts. The THF-containing acetogenins induced G2/M phase arrest, mitochondrial damage and apoptosis, and increased cytosolic and mitochondrial Ca2+ in NPCs. Microarray analysis of NPC-TW01 cells treated with squamostatin A, a non-adjacent bis-THF acetogenin, demonstrated an increased endoplasmic reticulum (ER)-stress response (ESR). Enhanced ESR in squamostatin A-treated cells was confirmed by real-time PCR, Western blot and shRNA gene knockdown experiments. Although our results showed that squamostatin A-induced ESR was independent of extracellular Ca2+, the presence of extracellular Ca2+ enhanced the antiproliferative effect of acetogenins. In vivo analyses demonstrated that squamostatin A showed good pharmacokinetic properties and significantly retarded NPC tumor growth in the xenograft mouse model. Conclusively, our work demonstrates that acetogenins are effective and selective inducers of the ESR that can block NPC proliferation, and illustrate a previously unappreciated antitumor mechanism of acetogenins that is effective against nasopharyngeal malignancies.

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Treatment of nasopharyngeal carcinoma in children and adolescents

Abstract: These participating institutions recruited patients into the study and are listed in alphabetical order. The number of patients recruited appears after each researcher's name. Departments of Pediatric Hematology and Oncology 1 and

Cited by 102 publications

References 63 publications

A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma

A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma

Current Status of Cancer Care for Young Patients with Nasopharyngeal Carcinoma in Jakarta, Indonesia

Mechanistic Study of Tetrahydrofuran- acetogenins In Triggering Endoplasmic Reticulum Stress Response-apotoposis in Human Nasopharyngeal Carcinoma

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