title: Systematic review and individual patient data analysis of pediatric head and neck squamous cell carcinoma: An analysis of 217 cases.
abstract: BACKGROUND
  Pediatric head and neck Squamous cell carcinoma (PHNSCC) is a rare disease. The optimum treatment and outcome remains poorly understood because of rarity.
  
  
  METHODS
  We conducted an individual patient data analysis of PHNSCC. Two authors independently searched PubMed, google search, and Cochrane library for eligible studies using following search words: Pediatric Head and neck squamous cell carcinoma, Head and neck squamous cell carcinoma under age of 20, Head and neck squamous cell carcinoma in young, PHNSCC till June 1, 2016 published in English language.
  
  
  RESULTS
  Total of 217 patients of PHNSCC were found in the literature. Median age among the cohort was 15 years (Range: 0-20 years) with a clear male preponderance. Oral cavity tumors were commonest 75 (70%) followed by laryngeal neoplasms 16(15%). Median disease free survival was 9 months (Range: 0-216 months). Median overall survival was 48 months (Range: 1-216 months). In univariate analysis treatment modality had significant impact on disease free survival (DFS). Whereas, patients treated with Surgery, Laryngeal primary had significantly better OS. Patients with associated fanconis anemia had significantly worse overall survival (OS).
  
  
  CONCLUSIONS
  PHNSCC is a rare disease with poorer outcome. Associated DNA defects leads to poorer OS. Patients treated with surgery alone or surgery followed by adjuvant radiation had better DFS and OS. Molecular profiling and personalized therapy may improve survival with limited toxicity.
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: bpmmc24@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Bhanu Prasad
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: drsupriyamallick@gmail.com.
authors.forename: Supriya
authors.initials: S
authors.lastname: Mallick
authors.affiliation: Department of Bio-Statistics, All India Institute of Medical Sciences, New Delhi, India. Electronic address: adu361976@rediffmail.com.
authors.forename: Ashish Dutt
authors.initials: AD
authors.lastname: Upadhyay
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: gkrath2006@gmail.com.
authors.forename: G K
authors.initials: GK
authors.lastname: Rath
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy; D059186:Chemoradiotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D018572:Disease-Free Survival; D005199:Fanconi Anemia / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D008297:Male; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures; D010610:Pharyngeal Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D057285:Precision Medicine; D011379:Prognosis; D011878:Radiotherapy; D018714:Radiotherapy, Adjuvant; D017678:Sex Distribution; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D055815:Young Adult
keywords: Head and neck; Pediatric; Radiotherapy; Squamous cell carcinoma