title: Pediatric nasopharyngeal carcinoma: Experience from a tertiary cancer center in India.
abstract: BACKGROUND
  Pediatric nasopharyngeal carcinomas (NPCs) are rare tumors. There is paucity of data on outcomes in pediatric NPC from developing countries.
  
  
  OBJECTIVE
  The present study was conducted to ascertain the outcomes of children with NPC at our center.
  
  
  METHODS
  A retrospective analysis of case records of pediatric NPC patients treated at our hospital was performed.
  
  
  METHODS
  We analyzed the outcomes of 37 consecutive patients <18 years of age with pediatric NPC treated between 2000 and 2015. Patients were treated with concurrent chemoradiotherapy (CTRT) with cisplatin and 5-fluorouracil (5-FU) or CTRT with cisplatin, followed by adjuvant chemotherapy with cisplatin and 5-FU.
  
  
  METHODS
  Survival was analyzed using Kaplan-Meier method, and log rank test was used to compare variables.
  
  
  RESULTS
  The median duration of follow-up was 36.6 months. The median age of the patients was 15 years, and 22/37 (59%) patients were male. The most common presenting complaint was neck mass (70%), followed by nasal bleeding (16%). The distribution of Stage I, II, III, and IV patients was 1/37 (3%), 2/37 (6%), 13/37 (35%), and 21/37 (57%), respectively. Distant metastasis at presentation was seen in 3/37 patients. Complete response was seen in 32/37 (86%) patients. The 3-year event-free survival (EFS) for the entire cohort of patients was 60.1%. No significant difference in EFS was observed with age, gender, stage, use of 5-FU with CTRT, and nutritional status.
  
  
  CONCLUSIONS
  Majority of patients with pediatric NPC present with advanced stage disease at our center. No difference in outcomes was seen with the two schedules of CTRT. Local control could be achieved in majority of patients; however, distant metastasis was the most common reason for relapse.
authors.affiliation: Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: V
authors.initials: V
authors.lastname: Radhakrishnan
authors.affiliation: Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: S
authors.initials: S
authors.lastname: Totadri
authors.affiliation: Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: P
authors.initials: P
authors.lastname: Ganesan
authors.affiliation: Department of Radiotherapy, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: G
authors.initials: G
authors.lastname: Selvaluxmy
authors.affiliation: Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: T
authors.initials: T
authors.lastname: Ganesan
authors.affiliation: Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: M
authors.initials: M
authors.lastname: Dhanushkodi
authors.affiliation: Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
authors.forename: T
authors.initials: T
authors.lastname: Sagar
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma; D059248:Chemoradiotherapy; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007194:India; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D062606:Tertiary Care Centers
chemical_list: D002945:Cisplatin; D005472:Fluorouracil