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Radiation Oncology

, 9:274

Clinical Radiation Oncology


BackgroundTo evaluate the clinical features, treatment results, prognostic factors and late toxicities of nasopharyngeal carcinoma in children and adolescents.

MethodsBetween January 1990 and January 2011, 158 NPC patients younger than 20 years old were treated in our institution, and the patient’s clinical characteristics, treatment modalities, outcomes and prognostic factors were retrospectively analyzed.

ResultsThere were 9 5.7% patients in stage II, 60 38.0% in stage III and 89 56.3% in stage IV according to the UICC2002 staging system. Neck mass 32.3%, headache 21.5% and nasal obstruction 15.2% were the most common chief complaints. With a median follow-up time of 62.5 months range 2.0-225.0 months, the 5-year overall survival OS rate, local-regional control LRC rate and distant metastasis-free survival DMFS rate were 82.6%, 94.9% and 76.4%, respectively. There were 43 27.2% patients failed during the follow up, with seven local-regional recurrences and 38 distant metastases. In univariate analysis, the 5-year OS of T4 and T1-3 were 75% and 87.9%, p = 0.01, stage IV and stage II-III were 77.1% and 90%, p = 0.04, respectively. In multivariate analysis, T4 p = 0.02 and stage IV p = 0.04 were the independent adverse prognostic factors for OS. Significant reduction in trismus 27.3% v 3.6%, p = 0.03 and G2 xerostomia 37.9% v 10.3%, p = 0.02 was observed in patients treated by IMRT.

ConclusionsMost childhood and adolescence nasopharyngeal carcinoma patients were locally advanced diseases at first diagnosed. The treatment results of radiotherapy, with or without chemotherapy, are excellent in our institution. Reducing distant metastasis with new strategies and late toxicities with intensity-modulated radiotherapy are the future directions for the treatment of adolescent nasopharyngeal carcinoma.

KeywordsNasopharyngeal carcinoma Childhood Adolescence Radiotherapy Prognosis AbbreviationsNPCNasopharyngeal carcinoma

IMRTIntensity-modulated radiation therapy

GTVpGross tumor volume primary

GTVndGross tumor volume lymph node

LRCLocal-regional control

DMFSDistant metastasis free survival

OSOverall survival

3D-CRT3 dimensional- conformal radiation therapy

Electronic supplementary materialThe online version of this article doi:10.1186-s13014-014-0274-7 contains supplementary material, which is available to authorized users.

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Autor: Weixin Liu - Yuan Tang - Li Gao - Xiaodong Huang - Jingwei Luo - Shiping Zhang - Kai Wang - Yuan Qu - Jianping Xiao - Guo


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