Treatment outcome of childhood nasopharyngeal carcinoma: a single institution experience

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Marina Nikitovic, Marija Popovic-Vukovic, Dragana Stanic, Jelena Bokun, Lejla Paripovic, Vesna Ilic, Ivana Miskovic, Milan Saric

Abstract

Objectives

Nasopharyngeal carcinoma is a rare malignancy in children. The aim of this study was to provide analysis of children with nasopharyngeal carcinoma treated in a single institution.

Methods and materials

Between 1999 and 2016, fourteen pediatric patients with a diagnosis of undifferentiated nasopharyngeal carcinoma were treated in our institution, and the patients' clinical characteristics, treatment modality, outcome, and toxicity were analyzed.

Results

The median age at diagnosis was 15,5 years. The gender ratio was 1:1. The majority of patients had regionally and/or locally advanced tumors and one had bone metastases at the time of diagnosis. All patients received chemotherapy before radiotherapy, with partial response in thirteen patients and complete response in one. Radiation dose to the primary tumor and involved cervical lymph nodes was 55-60 Gy, uninvolved cervical and supraclavicular regions received prophylactic radiation with dose of 45-50 Gy. Ten patients received adjuvant chemotherapy. Three-year time to progression (TTP) and three-year overall survival (OS) rates were 75% and 73% respectively. Five-year TTP was 65% and OS 63% respectively, and after ten years TTP and OS remained the same. At the end of follow-up period, ten patients were alive, and four died. All of the patients that had distant metastases died. Most common late complications were skin fibrosis and xerostomia.

Conclusions

Multimodal therapy of children with nasopharyngeal carcinoma is associated with long-term survival. It is expected that further advances in the management of these patients, with improved radiotherapy and chemotherapy, will reduce acute and late toxicity and improve quality of life of treated children.

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