title: Nasopharyngeal carcinoma in children and adolescents - a single institution experience of 158 patients.
abstract: BACKGROUND
  To evaluate the clinical features, treatment results, prognostic factors and late toxicities of nasopharyngeal carcinoma in children and adolescents.
  
  
  METHODS
  Between January 1990 and January 2011, 158 NPC patients younger than 20 years old were treated in our institution, and the patient's clinical characteristics, treatment modalities, outcomes and prognostic factors were retrospectively analyzed.
  
  
  RESULTS
  There were 9 (5.7%) patients in stage II, 60 (38.0%) in stage III and 89 (56.3%) in stage IV according to the UICC2002 staging system. Neck mass (32.3%), headache (21.5%) and nasal obstruction (15.2%) were the most common chief complaints. With a median follow-up time of 62.5 months (range 2.0-225.0 months), the 5-year overall survival (OS) rate, local-regional control (LRC) rate and distant metastasis-free survival (DMFS) rate were 82.6%, 94.9% and 76.4%, respectively. There were 43 (27.2%) patients failed during the follow up, with seven local-regional recurrences and 38 distant metastases. In univariate analysis, the 5-year OS of T4 and T1-3 were 75% and 87.9%, p=0.01, stage IV and stage II-III were 77.1% and 90%, p=0.04, respectively. In multivariate analysis, T4 (p=0.02) and stage IV (p=0.04) were the independent adverse prognostic factors for OS. Significant reduction in trismus (27.3% v 3.6%, p=0.03) and G2 xerostomia (37.9% v 10.3%, p=0.02) was observed in patients treated by IMRT.
  
  
  CONCLUSIONS
  Most childhood and adolescence nasopharyngeal carcinoma patients were locally advanced diseases at first diagnosed. The treatment results of radiotherapy, with or without chemotherapy, are excellent in our institution. Reducing distant metastasis with new strategies and late toxicities with intensity-modulated radiotherapy are the future directions for the treatment of adolescent nasopharyngeal carcinoma.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. liuweixin1988@yeah.net.
authors.forename: Weixin
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. tangyuan82@126.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. li_gao2008@outlook.com.
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. whxd010@gmail.com.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. nqluo202@163.com.
authors.forename: Jingwei
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. zhshp1@hotmail.com.
authors.forename: Shiping
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. kaiwang2001@vip.sina.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. qu_yuan01@163.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Qu
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. jpxiao8@163.com.
authors.forename: Jianping
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. guozhenxu@vip.sina.com.
authors.forename: Guozhen
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences. No 17, Panjiayuannanli, Chaoyang District, Beijing, 100021, China. yijunlin1969@163.com.
authors.forename: Junlin
authors.initials: J
authors.lastname: Yi
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; 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; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology; D011878:Radiotherapy / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents