title: Long-Term Outcomes of Nasopharyngeal Carcinoma in 148 Children and Adolescents.
abstract: The aim of this study was to investigate the survival and long-term morbidities of nasopharyngeal carcinoma (NPC) in children and adolescents.We retrospectively reviewed children and adolescents with NPC treated at Sun Yat-sen University Cancer Center from February 1991 to October 2010, where the prognostic factors and long-term effects of therapy were analyzed.A total of 148 patients were identified. The median age was 15 years old (range, 5-18 years) and the male to female ratio was 3.6:1. Most of the tumor histopathology was undifferentiated nonkeratinizing carcinoma (97.3%). The number of patients staged with IVa, IVb, IVc, III, and II were 45 (30.4%), 12 (8.1%), 5 (3.4%), 70 (47.3%), and 16 (10.8%), respectively. For the whole series with a median follow-up of 81 months (range, 6-282 months), the 5-year overall survival (OS) and disease-free survival (DFS) ratios were 79.3% and 69.7%, respectively. We observed significant differences in the 5-year OS (81.1% vs 25.0%, P = 0.002) and the DFS rates (72.2% vs 0.0%, P = 0.000) between patients with stage II to IVb disease and stage IVc disease. For patients with stage II, III, IVa, and IVb disease, we found a high radiation dose (dose > 66 Gy to the primary lesion) would not significantly improve the survival compared to the sub-high radiation dose group (dose = 60-66 Gy to the primary lesion), even considering the type of radiation therapy technologies. However, the incidences of sequelae (grades I-IV) in patients with high radiation dose were apparently higher than those in patients with low radiation dose.Considering the late sequelae, a dose of 60 to 66 Gy to the primary lesions seems to be enough for children and adolescents with NPC.
authors.affiliation: From the State Key Laboratory of Oncology in South China (SL, HC, XS, ZZ, FS, JZ, JW, JH, RL, XG, LL, YG); Collaborative Innovation Center of Cancer Medicine (SL, HC, XS, ZZ, FS, JZ, JW, JH, RL, XG, LL, YG); and Departments of Pediatric Oncology (SL, XS, ZZ, FS, JZ, JW, JH, RL, XG) and Radiation Oncology (HC, LL, YG), Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Suying
authors.initials: S
authors.lastname: Lu
authors.forename: Hui
authors.initials: H
authors.lastname: Chang
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Sun
authors.forename: Zijun
authors.initials: Z
authors.lastname: Zhen
authors.forename: Feifei
authors.initials: F
authors.lastname: Sun
authors.forename: Jia
authors.initials: J
authors.lastname: Zhu
authors.forename: Juan
authors.initials: J
authors.lastname: Wang
authors.forename: Junting
authors.initials: J
authors.lastname: Huang
authors.forename: Ru
authors.initials: R
authors.lastname: Liao
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Guo
authors.forename: Lixia
authors.initials: L
authors.lastname: Lu
authors.forename: Yuanhong
authors.initials: Y
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China; D003131:Combined Modality Therapy; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate