Treatment results of 59 young patients with nasopharyngeal carcinoma

Selek, Uğur; Özyar, Enis; Özyiğit, Gökhan; Varan, Ali; Büyükpamukçu, Münevver; Atahan, I. Lale

doi:10.1016/j.ijporl.2004.09.001

Cited by 20 publications

(11 citation statements)

References 41 publications

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“…Previous retrospective studies have reported the survival benefit offered by radiotherapy combined with chemotherapy in pediatric and adolescent NPC[3],[16],[17]. In this study, 30 patients (88.2%) received chemotherapy and the 5-year overall survival for the entire cohort was 88.2%.…”

Section: Discussionmentioning

confidence: 70%

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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Section: Discussionmentioning

confidence: 70%

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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“…However, randomised data in paediatric population comparing sequential CT + RT with concurrent treatment do not exist. Furthermore, although our study demonstrates a benefit to CT given sequentially relative to RT and is important to show that a greater total number of CT cycles correlates favourably with overall survival largely due to decreased distant failure, a standard protocol for paediatric NPC is yet to be identified, and more prospective randomised studies evaluating the addition of interferon or immunotherapy to CT and RT should be performed (7,23,36,(38)(39)(40)(41).…”

Section: Discussionmentioning

confidence: 94%

“…Several studies also have tested neoadjuvant cisplatin-based CT in paediatric NPC. The results are conflicting, and Retrospectively analysing 59 patients with NPC who were £30 years, Selek et al (36) also stated that RT combined with multi-agent CT was effective in achieving satisfactory disease-free survival and comparable overall survival in young patients with NPC.…”

Section: Discussionmentioning

confidence: 99%

The efficiency of different chemoradiotherapy regimens in patients with paediatric nasopharynx cancer: review of 46 cases

Bakkal¹,

Kaya²,

Berberoĝlu

et al. 2006

International Journal of Clinical Practice

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The purpose of this study was to evaluate the role of combined modality treatment in patients with paediatric nasopharynx cancer (NPC). Forty-six patients with paediatric NPC were retrospectively analysed. Forty-four of 46 patients received combined modality treatment. Five-year overall survival and progression-free survivals were 70% and 72% for the whole group, and only three of 46 patients had loco-regional relapse. Complete remission was obtained in 18 of 45 patients (40%), and the overall survival (94% vs. 62% and 19%, p = 0.0009) and disease-free survivals (93% vs. 70% and 16%, p = 0.0002) were significantly better in complete responders when compared with the patients who had partial response or stable disease. The 5-year overall survival and disease-free survivals of the patients who received neoadjuvant chemotherapy (CT) and radiotherapy (RT) followed by CT were superior to the other groups (77% and 80%, respectively). The number of total CT cycles (p = 0.0001), nodal stage (p = 0.05) and treatment response (p = 0.0009) were significant prognostic factors for overall survival. The treatment type (p = 0.02), the number of total CT cycles (p = 0.0006), nodal stage (p = 0.05) and treatment response (p = 0.0002) were found as significant prognostic factors for disease-free survival. The survival of patients receiving six or more CT cycles was also significantly better than that of patients receiving less than six cycles (p = 0.0001). In patients with locally advanced paediatric NPC, CT should be added to RT to improve outcome. However, a standard protocol is yet to be identified, and further studies evaluating the addition of interferon or immunotherapy to CT and RT shall be performed.

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“…[1][2][3] The annual incidence of NPC ranges from 80 per 100,000 in southern China, southeast Asia, the Mediterranean Basin, and Alaska to 1 per 100,000 in the continental United States. 4,5 The majority of children diagnosed with NPC have World Health Organization (WHO) type III (undifferentiated) histology, advancedstage disease, and tumor or serologic markers associated with Epstein-Barr virus (EBV) infection.…”

mentioning

confidence: 99%

“…2,[5][6][7][8][9] Regimens incorporating platinum-based chemotherapy and highdose radiation therapy improved the overall survival rates from 8% to greater than 70% in pediatric patients with advanced-stage NPC. 3,6,7,10,11 In 1996, St Jude Children's Research Hospital reported prolonged remission in 21 of 22 patients treated on their NPC-1 protocol that used 4 courses of induction chemotherapy with methotrexate, leucovorin rescue, cisplatin, and 5-fluorouracil (5-FU) followed by conformal radiation therapy. 7,10 After these encouraging results, a phase II Pediatric Oncology Group clinical trial (POG 9486) using the same chemotherapy backbone reported a 75% 4-year overall survival rate in 18 pediatric patients with NPC.…”

mentioning

confidence: 99%

A Single Institution Experience With Pediatric Nasopharyngeal Carcinoma: High Incidence of Toxicity Associated With Platinum-based Chemotherapy Plus IMRT

Louis

Paulino

Gottschalk

et al. 2007

Journal of Pediatric Hematology/Oncology

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Treatment results of 59 young patients with nasopharyngeal carcinoma

Cited by 20 publications

References 41 publications

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

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

The efficiency of different chemoradiotherapy regimens in patients with paediatric nasopharynx cancer: review of 46 cases

A Single Institution Experience With Pediatric Nasopharyngeal Carcinoma: High Incidence of Toxicity Associated With Platinum-based Chemotherapy Plus IMRT

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