Berberoğlu S, Ilhan I, Cetindağ F, Sunter O
Oncology Hospital, Department of Pediatric Oncology, Demetevler, Ankara, Turkey.
Pediatr Hematol Oncol. 2001 Jul-Aug;18(5):309-15. doi: 10.1080/088800101300312573.
A retrospective and prospective analysis is reported of epidemiological, clinical, and therapeutic aspects of 33 children with nasopharyngeal carcinoma who were treated in a single institution over a period of 10 years. Twenty-three male and 10 female children ranging from 9 to 17 years were referred to our center. Histopathology was WHO type 3 carcinoma in 21, WHO type 2 in 8, WHO type 1 in 1, and unclassified in 3 patients. Disease extent was T2a (n = 15), T2b (n = 2), T3 (n = 11), and T4 (n = 5); N1 (n = 5), N2 (n = 12), and N3a (n = 16). Five patients had base of skull invasion. Four patients had M1 disease on admission. Four patients were treated with irradiation only. Three patients received neoadjuvant, 4 patients received adjuvant, and 22 patients received neoadjuvant + adjuvant chemotherapy in addition to radiotherapy. Patients received 50-72 Gy to the primary tumor and involved nodes and 45-50 Gy to uninvolved regions. Chemotherapy consisted of combinations of cisplatin, fluorouracil or Adriamycin, vincristine, and cyclophosphamide. Twenty-nine patients (88%) attained locoregional control. Overall, 10 patients died with progressive disease or infectious complications, and 2 patients are still receiving therapy. Three patients are still living with multiple metastases and stable disease. Eight patients were lost to follow-up. Twelve patients are alive without relapse 3 and 63 months from diagnosis. Seven patients had 6 relapses at distant and 1 relapse at local site. The median time for first relapse was 8 months. Overall, the 5-year survival rate was 63% and disease-free survival rate was 53%. Although the locoregional control rate is high, long-term survival rates will be the real test of the impact of chemotherapy. Further studies are needed to confirm the optimal combination of effective chemotherapeutic agents and radiotherapy.
本文报告了对一家机构在10年期间治疗的33例鼻咽癌儿童患者的流行病学、临床和治疗方面进行的回顾性和前瞻性分析。23例男性和10例女性儿童，年龄在9至17岁之间，被转诊至我们中心。组织病理学检查结果为：21例为WHO 3型癌，8例为WHO 2型，1例为WHO 1型，3例未分类。疾病范围为T2a（n = 15）、T2b（n = 2）、T3（n = 11）和T4（n = 5）；N1（n = 5）、N2（n = 12）和N3a（n = 16）。5例患者有颅底侵犯。4例患者入院时已有M1期疾病。4例患者仅接受了放疗。3例患者接受了新辅助化疗，4例患者接受了辅助化疗，22例患者除放疗外还接受了新辅助+辅助化疗。患者对原发肿瘤和受累淋巴结接受50 - 72 Gy的照射，对未受累区域接受45 - 50 Gy的照射。化疗方案包括顺铂、氟尿嘧啶或阿霉素、长春新碱和环磷酰胺的联合应用。29例患者（88%）实现了局部区域控制。总体而言，10例患者因疾病进展或感染并发症死亡，2例患者仍在接受治疗。3例患者仍有多处转移且病情稳定。8例患者失访。12例患者在诊断后3个月至63个月无复发存活。7例患者有6次远处复发和1次局部复发。首次复发的中位时间为8个月。总体而言，5年生存率为63%，无病生存率为53%。尽管局部区域控制率较高，但长期生存率将是化疗效果的真正考验。需要进一步研究以确定有效化疗药物与放疗的最佳联合方案。
