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Pediatric nasopharyngeal carcinoma: Experience from a tertiary cancer center in India
V Radhakrishnan1, P Kumar1, S Totadri1
1Department of Medical and Pediatric Oncology, Cancer Institute (W.I.A.), Chennai, Tamil Nadu, India.
Background:
Pediatric nasopharyngeal carcinomas (NPCs) are rare tumors. There is paucity of data on outcomes in pediatric NPC from developing countries.
Aim:
The present study was conducted to ascertain the outcomes of children with NPC at our center.
Settings And Design:
A retrospective analysis of case records of pediatric NPC patients treated at our hospital was performed.
Patients And 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.
Statistical Analysis:
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.
Conclusion:
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.
