Treatment results of pediatric nasopharyngeal carcinoma, NCI, Cairo University experience

Abstract EN

Background: Investigate treatment outcome, prognostic factors and survival among selected group of Egyptian pediatric nasopharyngeal carcinoma patients.

Patients and methods: Thirty patients treated from non-metastatic nasopharyngeal carcinoma between 1997 and 2012 were retrospectively evaluated including: TNM staging, chemoradiotherapy regimens.

Survival analysis was done using Kaplan–Meier survival curves.

Results: Twenty-three males and 7 females (M:F 3.2:1) with median age of 14 years; 84% with stages III/IV.

Neck node enlargement was reported in 90% (27/30).

Induction chemotherapy followed by radiotherapy was implemented in 80% of patients.

Mucositis (87%) was the commonest treatment related toxicity.

Nineteen patients (63%) were in CR with a median FU of 69 months (range 24–160).

Eleven patients had treatment local and distant failures (2 local, 7 distant and 2 local/distant) at a median FU of 24 and 34 months respectively.

5-year overall and event-free survival rates were 77% and 63% respectively.

Prolonged OAP of RT P 50 days, Hb < 11 g% and T4 stage affected EFS and OAS on UVA; while on MVA; prolonged OAP of RT P 50 days (p=0.002) and T4 stage (p= 0.004) affected EFS and only Hb <11 g% (p= 0.019) affected OAS.

Late toxicity was reported in 70% of irradiated patients.

Conclusion: Radio-chemotherapy management for pediatric NPC resulted in comparable treatment outcomes with tolerable late effects.

Response adapted radio-chemotherapy regimens in addition to the potential use of IMRT should be recommended to decrease treatment related side effects.

Prolonged OAP of RT P 50 days and low Hb level were encountered as adverse prognostic factors; findings that need further investigation.

ª 2015 The Authors.

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on behalf of National Cancer Institute, Cairo University.

This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).