NASOPHARYNGEAL CARCINOMA IN CHILDREN - RETROSPECTIVE REVIEW OF 50 PATIENTS

Purpose: To report a retrospective analysis of epidemiologic, clinical , and therapeutic aspects of 50 children with newly diagnosed nasophar yngeal carcinoma who were treated in a single institution over a perio d of 18 years. Methods and Materials: Thirty-two male and 18 female ch ildren ranging from 5 to 16 years, accounted for 7.2% of all nasophary ngeal carcinoma cases and 52% of childhood nasopharyngeal malignancies . Histopathology was World Health Organization Type 3 carcinoma in 45, World Health Organization Type 2 in 4, and World Health Organization Type 1 in one patient. Two of the patients had missing information for staging and treatment evaluation. Disease extent was T1 (n = 4), T2 ( n = 9), T3 (n = 21), and T4 (n = 14); NO (n = 1), N1 (n = 6), N2 (n = 12), and N3 (n = 29), Six patients had base of skull invasion, two had cranial nerve palsies, and six had both, One patient had M1 disease o n admission, Twenty-three patients were treated with irradiation only, Thirteen patients received adjuvant, and 12 had neoadjuvant chemother apy in addition to radiotherapy, Patients received 50-72 Gy to the pri mary tumor and involved nodes, and 45-50 Gy to uninvolved regions, Che motherapy consisted of combinations including cisplatin, bleomycin, ep irubicin, 5-flouroucil, and cyclophosphamide. Results: Thirty-eight (7 9%) patients attained locoregionel control. Overall, 22 patients are a live without relapse 6-195 months from diagnosis, Thirteen patients ha d 21 relapses, at local and/or regional sites (43%), distant sites (48 %), or both (9%), The median time for first relapse was 8 months. Over all, the 5-and 10-year survival rates were 52 and 52%, respectively, a nd the failure-free survival rates were both 53%, The results of three distinct treatments given in subsequent time periods were not statist ically different, Three second malignancies occurred 33-156 months fol lowing nasopharyngeal carcinoma diagnosis. Conclusion: In the current series, nasopharyngeal carcinoma patients under the age of 16 accounte d for 7.2% of all nasopharyngeal carcinoma cases, Whereas the impact o f chemotherapy on long-term survival remains to be determined by rando mized studies, the results suggest that more effective treatment regim ens and long-term follow-up are necessary for children with nasopharyn geal carcinoma.