Nasopharyngeal carcinoma in children under 15 years of age: A retrospective review of 65 patients

Background: Nasopharyngeal carcinoma constitutescomprises up to 5% of prima ry childhood cancers but literature lacks modern uniformly treated large se ries. Patients and methods: A retrospective review was performed of sixty-five pr eviously untreated patients younger than 16 years of age diagnosed and trea ted at the Ibn Rochd Centre in Casablanca between 1988 and 1992. Forty-four percent of them were stage T-3 to T-4 and 66% stage N-2 or N-3. All patien ts were irradiated. Prior adjuvant chemotherapy was administered in 33 pati ents. Thirteen patients were lost to follow-up. Results: Local control was obtained in 85% of the 52 evaluable patients. Th e five-year overall survival was 42% and disease-free survival 38%. Ten rel apses occurred at local and/or regional sites. Six patients have distant me tastases. All 24 patients with relapse or persistent disease died despite s alvage therapy. Stage, histology and dose of radiation, were statistically significant prognostic variables. Patients treated with chemotherapy follow ed by irradiation had a better outcome than those treated with radiation al one. Conclusions: Nasopharyngeal carcinoma in children is a rare chemosensitive tumor. However, conclusive treatment guidelines cannot be drawn from this s eries and prospective co-operative studies are needed for the development o f more effective and less toxic therapeutic strategies.