title: Multimodal treatment, including interferon beta, of nasopharyngeal carcinoma in children and young adults: preliminary results from the prospective, multicenter study NPC-2003-GPOH/DCOG.
abstract: BACKGROUND
  The authors report preliminary results from a prospective multicenter study (Nasopharyngeal Carcinoma [NPC] 2003 German Society of Pediatric Oncology and Hematology/German Children's Oncology Group [NPC-2003-GPOH/DCOG]).
  
  
  METHODS
  From 2003 to 2010, 45 patients (ages 8-20 years), including 1 patient with stage II NPC and 44 patients with stage III/IV NPC, were recruited to the study. The patient with stage II disease received radiotherapy (59.4 grays [Gy]). The patients with stage III/IV disease received 3 courses of neoadjuvant chemotherapy with cisplatin, 5-fluorouracil, and folinic acid. The cumulative irradiation dose was 54 Gy in 5 patients, who achieved complete remission after neoadjuvant chemotherapy, and 59.4 Gy in the remaining 40 patients. All patients received concomitant cisplatin during the first week and last week of irradiation. After irradiation, all patients received interferon beta for 6 months. Tumor response was evaluated by magnetic resonance imaging studies and positron emission tomography scans.
  
  
  RESULTS
  After the completion of treatment, 43 of 45 patients were in complete remission. In 2 patients, only a partial response was achieved, followed by distant metastases (1 patient) or local progression and distant metastases (1 patient), 6 months and 10 months after diagnosis, respectively. Another patient developed a solitary pelvic bone metastasis 21 months after diagnosis. After a median follow-up of 30 months (range, 6-95 months), the event-free survival rate was 92.4%, and the overall survival was 97.1%. Acute toxicity consisted mainly of leucopenia, mucositis, and nausea; and late toxicity consisted of hearing loss and hypothyroidism.
  
  
  CONCLUSIONS
  Combined therapy with neoadjuvant chemotherapy, radiochemotherapy, and interferon beta was well tolerated and resulted in a very good outcome that was superior to the outcomes of published results from all other pediatric NPC study groups.
authors.affiliation: Department of Pediatric and Adolescent Medicine, University Hospital Aachen, Aachen, Germany. mbuehrlen@ukaachen.de
authors.forename: Martina
authors.initials: M
authors.lastname: Buehrlen
authors.forename: Christian Michel
authors.initials: CM
authors.lastname: Zwaan
authors.forename: Bernd
authors.initials: B
authors.lastname: Granzen
authors.forename: Lisa
authors.initials: L
authors.lastname: Lassay
authors.forename: Peter
authors.initials: P
authors.lastname: Deutz
authors.forename: Peter
authors.initials: P
authors.lastname: Vorwerk
authors.forename: Gundula
authors.initials: G
authors.lastname: Staatz
authors.forename: Günther
authors.initials: G
authors.lastname: Gademann
authors.forename: Hans
authors.initials: H
authors.lastname: Christiansen
authors.forename: Foppe
authors.initials: F
authors.lastname: Oldenburger
authors.forename: Miriam
authors.initials: M
authors.lastname: Tamm
authors.forename: Rolf
authors.initials: R
authors.lastname: Mertens
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma; D059186:Chemoradiotherapy, Adjuvant; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005858:Germany; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012074:Remission Induction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016899:Interferon-beta; D002945:Cisplatin; D005472:Fluorouracil