Nasopharyngeal carcinoma in the second decade of life

The clinical findings and treatment results in 27 patients, 11 to 20 years of age, with nasopharyngeal carcinoma were retrospectively reviewed. The histological diagnosis was lymphoepithelioma in 18 patients and undifferentiated carcinoma in nine patients. Seven patients (26%) presented with T4 lesions, 24 patients (89%) with clinically positive cervical nodes, and two patients (7%) with distant metastases. All patients received radiation therapy to the primary site; chemotherapy was employed as an adjuvant in six patients. Overall survival was 64% at five years and 57% at 10 years. Local control of the primary tumor and regional lymph nodes was 85%. Distant metastases were more frequent in patients with advanced primary disease and were associated wtih extremely poor prognoses. A moderate dose of radiotherapy is the recommended treatment for primary tumors and neck nodes. More effective adjuvant chemotherapy is suggested as a possible way to improve therapeutic results.