Saeed Haleema, Zaidi Alia, Adhi Mehreen, Hasan Rabia, Dawson Amber
Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
Asian Pac J Cancer Prev. 2009;10(5):917-20.
This study aims to review the clinical features, treatment and outcome of pediatric nasopharyngeal Carcinoma at Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH and RC) over ten years.
Retrospective review of pediatric patients who were diagnosed with nasopharyngeal carcinoma and treated at SKMCH and RC from July 1996 to June 2006.
A total of 27 children with NPC were included. The male to female ratio was 4.4:1. The mean age at diagnosis was 14 years (8-18 years). The most common presenting symptom was neck swelling (81.5%, 22/27). The mean duration of symptoms before diagnosis was 10.3 months (3-36 months). The majority of patients (70%, 19/27) presented at stage IV. All received a combination of chemotherapy and radiotherapy. Survival analysis was performed for 22 patients; of these 8 patients died and 4 were lost to follow-up. The median follow-up time of the surviving patients was 53 months (5-116 months). At 5 years, the cumulative overall survival (OS) was 55% while the cumulative EFS was 54% with a flattening of the curve at 2 years. There was a significant difference in OS (p= 0.001) and EFS (p= 0.057) in patients diagnosed with NPC under 14 years of age (n= 11) and those between 14 and 18 years (n= 11).
In our institutional study, NPC presents late and in advanced stage. The outcome is better in younger children. Our survival rates, while comparable to developing countries, are less than those seen in the developed world. We feel a strong need for collaborative studies in view of small numbers in individual centres.
本研究旨在回顾十年间在沙卡特汗姆纪念癌症医院及研究中心（SKMCH和RC）就诊的儿童鼻咽癌的临床特征、治疗方法及治疗结果。
对1996年7月至2006年6月期间在SKMCH和RC被诊断为鼻咽癌并接受治疗的儿童患者进行回顾性研究。
共纳入27例儿童鼻咽癌患者。男女比例为4.4:1。诊断时的平均年龄为14岁（8 - 18岁）。最常见的首发症状是颈部肿胀（81.5%，22/27）。诊断前症状的平均持续时间为10.3个月（3 - 36个月）。大多数患者（70%，19/27）就诊时处于IV期。所有患者均接受了化疗和放疗联合治疗。对22例患者进行了生存分析；其中8例死亡，4例失访。存活患者的中位随访时间为53个月（5 - 116个月）。5年时，累积总生存率（OS）为55%，而累积无事件生存率（EFS）为54%，曲线在2年时趋于平稳。14岁以下（n = 11）和14至18岁（n = 11）被诊断为鼻咽癌的患者在总生存率（p = 0.001）和无事件生存率（p = 0.057）方面存在显著差异。
在我们机构的研究中，鼻咽癌就诊时较晚且处于晚期。年龄较小的儿童治疗结果较好。我们的生存率虽然与发展中国家相当，但低于发达国家。鉴于各个中心的病例数较少，我们强烈认为需要开展合作研究。
