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KMID : 0387820140210020114
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Clinical Pediatric Hematology-Oncology
2014 Volume.21 No. 2 p.114 ~ p.120
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Nasopharyngeal Carcinoma in Children and Adolescents: Single Institution Study
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Choi Jung-Yoon
Kang Hyoung-Jin
Ju Hee-Young
Hong Che-Ry
Kim Il-Han
Park Sung-Hye
Kim In-One
Park Kyung-Duk
Shin Hee-Young
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Abstract
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Background: Nasopharyngeal carcinoma (NPC) is very rare in children and adolescents. The aim of this study was to evaluate clinical characteristics and treatment outcomes of pediatric NPC.
Methods: Medical records of 9 patients treated for NPC at the Seoul National University Children’s Hospital between 1988 and 2012 were analyzed retrospectively.
Results: The median age at diagnosis was 11 years (range, 9?13 years). One patient had stage II disease, 3 had stage III disease, and 5 had stage IV disease. The histologic sub-types were undifferentiated carcinoma and squamous cell carcinoma in 7 and 2 patients, respectively. All patients were initially treated with cisplatin (100 mg/m2 intravenous [IV] every 4 weeks for 4?6 months), bleomycin (15 unit/m2 IV every 1 week×7), and fluo-rouracil (1,000 mg/m2 IV every 4 weeks for 1 year). Eight patients received radiotherapy with doses of 45-59.4 Gy at the primary site and neck nodes. Seven patients (77.8%) achieved complete remission, 1 (11.1%) achieved partial remission, and 1 (11.1%) showed disease progression. Six patients developed fluorouracil-related neurotoxicity; the regimen was changed to cisplatin, epirubicin, and bleomycin in five of the 6 patients. One patient died of progressive disease without responding to treatment. Treatment-re-lated mortality occurred in 1 patient owing to septic shock. Secondary osteosarcoma developed in 1 patient 6 years after treatment. The overall survival was 77.8%, with a median follow-up of 40.8 months (range, 4.5-287.6 months).
Conclusion: Children and adolescents with advanced NPC treated with combined chemo-therapy and radiotherapy have a good survival rate.
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KEYWORD
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Nasopharyngeal neoplasms, Pediatrics, Chemoradiotherapy, Korea
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