Treatment results of pediatric nasopharyngeal carcinoma, NCI, Cairo University experience

BackgroundInvestigate treatment outcome, prognostic factors and survival among selected group of Egyptian pediatric nasopharyngeal carcinoma patients.Patients and methodsThirty 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.ResultsTwenty-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 < 11 g% 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 < 11 g% (p = 0.019) affected OAS. Late toxicity was reported in 70% of irradiated patients.ConclusionRadio-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.