Clin Pediatr Hematol Oncol.  2014 Oct;21(2):114-120. 10.15264/cpho.2014.21.2.114.

Nasopharyngeal Carcinoma in Children and Adolescents: Single Institution Study

• Choi JY
• Kang HJ
• Ju HY
• Hong CR
• Kim IH
• Park SH
• Kim IO
• Park KD
• Shin HY

• KMID: 2279820
• DOI: http://doi.org/10.15264/cpho.2014.21.2.114

Abstract

BACKGROUND
Nasopharyngeal carcinoma (NPC) is very rare in children and adolescents. The aim of this study was to evaluate clinical characteristics and treatment outcomes of pediatric NPC.
METHODS
Medical records of 9 patients treated for NPC at the Seoul National University Children's Hospital between 1988 and 2012 were analyzed retrospectively.
RESULTS
The median age at diagnosis was 11 years (range, 9-13 years). One patient had stage II disease, 3 had stage III disease, and 5 had stage IV disease. The histologic subtypes were undifferentiated carcinoma and squamous cell carcinoma in 7 and 2 patients, respectively. All patients were initially treated with cisplatin (100 mg/m2 intravenous [IV] every 4 weeks for 4-6 months), bleomycin (15 unit/m2 IV every 1 weekx7), and fluorouracil (1,000 mg/m2 IV every 4 weeks for 1 year). Eight patients received radiotherapy with doses of 45-59.4 Gy at the primary site and neck nodes. Seven patients (77.8%) achieved complete remission, 1 (11.1%) achieved partial remission, and 1 (11.1%) showed disease progression. Six patients developed fluorouracil-related neurotoxicity; the regimen was changed to cisplatin, epirubicin, and bleomycin in five of the 6 patients. One patient died of progressive disease without responding to treatment. Treatment-related mortality occurred in 1 patient owing to septic shock. Secondary osteosarcoma developed in 1 patient 6 years after treatment. The overall survival was 77.8%, with a median follow-up of 40.8 months (range, 4.5-287.6 months).
CONCLUSION
Children and adolescents with advanced NPC treated with combined chemotherapy and radiotherapy have a good survival rate.

Keyword

Nasopharyngeal neoplasms; Pediatrics; Chemoradiotherapy; Korea

MeSH Terms

Adolescent*
Bleomycin
Carcinoma
Carcinoma, Squamous Cell
Chemoradiotherapy
Child*
Cisplatin
Diagnosis
Disease Progression
Drug Therapy
Epirubicin
Fluorouracil
Follow-Up Studies
Humans
Korea
Medical Records
Mortality
Nasopharyngeal Neoplasms
Neck
Osteosarcoma
Pediatrics
Radiotherapy
Retrospective Studies
Seoul
Shock, Septic
Survival Rate
Bleomycin
Cisplatin
Epirubicin
Fluorouracil