Childhood Nasopharyngeal Carcinoma: State-of-the-Art, and Questions for the Future.

Childhood Nasopharyngeal Carcinoma: State-of-the-Art, and Questions for the Future.

J Pediatr Hematol Oncol. 2018 Jan 03;:

Authors: Dourthe ME, Bolle S, Temam S, Jouin A, Claude L, Reguerre Y, Defachelles AS, Orbach D, Fresneau B

Abstract
In children, nasopharyngeal carcinoma (NPC) is a very rare tumor, mostly Epstein-Barr Virus related and quite always diagnosed at a locally advanced stage. With current protocols associating induction cisplatin-based chemotherapy and concomitant chemoradiotherapy, prognosis is excellent with overall survival higher than 85%. However, long-term toxicities are frequent. Improvement in radiation therapy modalities like intensity-modulated radiation therapy and new strategies with radiation dose adaptation to chemotherapy response have been introduced to reduce acute and long-term toxicities. Actually, 2 main questions remain: is it possible to pursue a therapeutic deescalation in children with low-risk NPC or very good response to induction chemotherapy in order to reduce the risk of late effects? Could an immunologic maintenance treatment improve prognosis of children with high-risk NPC? International collaborative groups and prospective trials including biological studies are necessary to answer these questions to improve childhood NPC treatment and knowledge.

PMID: 29300240 [PubMed - as supplied by publisher]

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