Nasopharyngeal carcinoma in childhood

We have retrospectively evaluated a series of 27 consecutive children observed from 1965 to 1980 with nasopharyngeal carcinoma (NPC). Histological diagnosis in each patient was undifferentiated carcinoma of nasopharyngeal type (UCNT) with prominent lymphocytic infiltration. Regional node involvement was present in 26 of 27 patients and two children presented with distant metastases. Twenty evaluable children with primary nasopharyngeal tumor with or without positive cervical nodes underwent radiotherapy (RT) with uniform criteria in technique. Adjuvant cyclophosphamide (CPM) was administered to a total of 11 children. The actuarial relapse-free survival and overall survival are 40% and 55% at four years, respectively. In this series, the most important prognostic factor was represented by the extent of the tumor in the nasopharynx. Permanent control of the primary tumor was obtained in 85% of patients. CPM given after RT did not reduce the incidence of relapse. However, the fact that 45% of patients developed distant metastases as first treatment failure suggests that combined chemotherapy should be tested in the management of NPC in children, especially when primary tumor is locally advanced.