title: Treatment results of pediatric nasopharyngeal carcinoma, NCI, Cairo University experience.
abstract: BACKGROUND
  Investigate treatment outcome, prognostic factors and survival among selected group of Egyptian pediatric nasopharyngeal carcinoma patients.
  
  
  METHODS
  Thirty patients treated from non-metastatic nasopharyngeal carcinoma between 1997 and 2012 were retrospectively evaluated including: TNM staging, chemo-radiotherapy regimens. Survival analysis was done using Kaplan-Meier survival curves.
  
  
  RESULTS
  Twenty-three males and 7 females (M:F 3.2:1) with median age of 14 years; 84% with stages III/IV. Neck node enlargement was reported in 90% (27/30). Induction chemotherapy followed by radiotherapy was implemented in 80% of patients. Mucositis (87%) was the commonest treatment related toxicity. Nineteen patients (63%) were in CR with a median FU of 69 months (range 24-160). Eleven patients had treatment local and distant failures (2 local, 7 distant and 2 local/distant) at a median FU of 24 and 34 months respectively. 5-year overall and event-free survival rates were 77% and 63% respectively. Prolonged OAP of RT⩾50 days, Hb<11g% and T4 stage affected EFS and OAS on UVA; while on MVA; prolonged OAP of RT⩾50 days (p=0.002) and T4 stage (p=0.004) affected EFS and only Hb<11g% (p=0.019) affected OAS. Late toxicity was reported in 70% of irradiated patients.
  
  
  CONCLUSIONS
  Radio-chemotherapy management for pediatric NPC resulted in comparable treatment outcomes with tolerable late effects. Response adapted radio-chemotherapy regimens in addition to the potential use of IMRT should be recommended to decrease treatment related side effects. Prolonged OAP of RT⩾50 days and low Hb level were encountered as adverse prognostic factors; findings that need further investigation.
authors.affiliation: Radiation Oncology & Nuclear Medicine Department, NCI, Cairo University, Egypt. Electronic address: Ehab.khalil@nci.cu.edu.eg.
authors.forename: Ehab M
authors.initials: EM
authors.lastname: Khalil
authors.affiliation: Public Health & Community Medicine, Faculty of Medicine, Beni-Sueif University, Egypt. Electronic address: M_anwarabdo@yahoo.com.
authors.forename: Manal M
authors.initials: MM
authors.lastname: Anwar
mesh_terms: D000293:Adolescent; D002277:Carcinoma; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Late toxicity; Nasopharyngeal carcinoma; Pediatric; Treatment results