Nasopharyngeal carcinoma in the pediatric age group: The Northern Israel (Rambam) Medical Center experience, 1989-2004

Motti Haimi, Myriam Weyl Ben Arush, Gil Bar-Sela, Eliahu Gez, Zvi Bernstein, Sergey Postovsky, Ayelet Ben Barak, Abraham Kuten

Research output: Contribution to journalArticlepeer-review

Abstract

Nasopharyngeal carcinoma (NPC) is rare in children, accounting for less than 1% of all malignancies. Radiation therapy has been the mainstay of treatment of many years, but to improve survival, the use of chemotherapy has been advocated. This is a retrospective analysis of 13 patients less than 20 years of age treated for NPC the Rambam Medical Center during 1989 to 2004. Eight boys and five girls with a median age of 14.5 years (range 10-19) were included. Median follow up (including patients who died) was 6.15 years (range 1-15 years). Duration of symptoms was 1 to 24 months (median 5 months). Of the 13 patients, one patient had stage I, 6 had stage III, 5 had stage IV-A, and 1 had stage IV-B disease. Ten patients (77%) had undifferentiated carcinoma (WHO type III) and three patients (23%) had nonkeratinizing carcinoma (WHO type II). Most of the children received two or three courses of neoadjuvant multiagent chemotherapy consisting of cisplatin and 5-FU, followed by radiotherapy with doses in excess of 60 Gy. One child received concomitant chemoradiation. Ten of the 13 patients (77%) are alive without disease 6 years after diagnosis (range 1-15 years). One patient developed local and distant metastases 1 year after diagnosis and is currently receiving combined radiochemotherapy. Two patients died. Overall survival was 84%; event-free survival was 77%. Nine patients (69%) developed moderate to severe long-term complications. Pediatric NPC is curable by combined radiation and chemotherapy, with doses of radiation in excess of 60 Gy. Long-term follow-up is important for early detection of second malignancies as well as for radiation-induced endocrinologic deficiencies and other normal tissue complications.

Original languageEnglish
Pages (from-to)510-516
Number of pages7
JournalJournal of Pediatric Hematology/Oncology
Volume27
Issue number10
DOIs
StatePublished - Oct 2005
Externally publishedYes

Keywords

  • Chemotherapy
  • Long-term complications
  • Nasopharyngeal carcinoma
  • Pediatric
  • Radiotherapy

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