title: Prognostic factors and long-term outcomes of nasopharyngeal carcinoma in children and adolescents.
abstract: BACKGROUND
  Nasopharyngeal carcinoma (NPC) is a rare malignancy in children and adolescents, and the optimal treatment modality in youths has not been established. The aim of this study was to evaluate the long-term treatment outcomes and complications associated with childhood and adolescent NPC.
  
  
  METHODS
  From January 1985 to December 2004, the records of 95 patients with NPC and younger than 20 years of age were reviewed. All of the records were confirmed based on pathology via biopsy. The radiation doses to the primary tumors ranged from 64 to 80 Gy. The radiation doses to the metastatic cervical lymph nodes ranged from 60 to 74 Gy. The fractionated doses ranged from 1.8 to 2.0 Gy at 5 fractions/week. A total of 36 patients received chemotherapy before radiotherapy.
  
  
  RESULTS
  The 1-, 3-, 5-, 10-, and 15-year overall survival (OS) rates were 92.6%, 63.2%, 54.7%, 46.8%, and 42.6%, respectively. The 1-, 3-, 5-, 10-, and 15-year disease-free survival (DFS) rates were 73.7%, 51.3%, 49.1%, 44.6%, and 42.6%, respectively. The clinical stage had a significant impact on OS (P = 0.007) and DFS (P = 0.012). Complete responders to therapy had superior OS (P < 0.001) and DFS (P < 0.001). Patients >12 years of age had better OS (P = 0.026) and DFS (P = 0.037).
  
  
  CONCLUSIONS
  Children and adolescents with advanced NPC had a relatively good rate of long-term survival. However, 28% of the survivors had serious long-term treatment-related morbidities. In addition to clinical stage and complete response or partial response, age was an independent prognostic factor in pediatric and adolescent NPC.
authors.affiliation: Department of Radiation Oncology, The Third Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Songliu
authors.initials: S
authors.lastname: Hu
authors.forename: Xiangying
authors.initials: X
authors.lastname: Xu
authors.forename: Jianyu
authors.initials: J
authors.lastname: Xu
authors.forename: Qingyong
authors.initials: Q
authors.lastname: Xu
authors.forename: Shanshan
authors.initials: S
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013995:Time; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents