Department of Radiation Oncology, The Third Affiliated Hospital of Harbin Medical University, Harbin, China.
Pediatr Blood Cancer. 2013 Jul;60(7):1122-7. doi: 10.1002/pbc.24458. Epub 2013 Jan 9.
Nasopharyngeal carcinoma (NPC) is a rare malignancy in children and adolescents, and the optimal treatment modality in youths has not been established. The aim of this study was to evaluate the long-term treatment outcomes and complications associated with childhood and adolescent NPC.
From January 1985 to December 2004, the records of 95 patients with NPC and younger than 20 years of age were reviewed. All of the records were confirmed based on pathology via biopsy. The radiation doses to the primary tumors ranged from 64 to 80 Gy. The radiation doses to the metastatic cervical lymph nodes ranged from 60 to 74 Gy. The fractionated doses ranged from 1.8 to 2.0 Gy at 5 fractions/week. A total of 36 patients received chemotherapy before radiotherapy.
The 1-, 3-, 5-, 10-, and 15-year overall survival (OS) rates were 92.6%, 63.2%, 54.7%, 46.8%, and 42.6%, respectively. The 1-, 3-, 5-, 10-, and 15-year disease-free survival (DFS) rates were 73.7%, 51.3%, 49.1%, 44.6%, and 42.6%, respectively. The clinical stage had a significant impact on OS (P = 0.007) and DFS (P = 0.012). Complete responders to therapy had superior OS (P < 0.001) and DFS (P < 0.001). Patients >12 years of age had better OS (P = 0.026) and DFS (P = 0.037).
Children and adolescents with advanced NPC had a relatively good rate of long-term survival. However, 28% of the survivors had serious long-term treatment-related morbidities. In addition to clinical stage and complete response or partial response, age was an independent prognostic factor in pediatric and adolescent NPC.
鼻咽癌（NPC）在儿童和青少年中较为罕见，青少年 NPC 的最佳治疗方式尚未确定。本研究旨在评估儿童和青少年 NPC 的长期治疗结果和相关并发症。
从 1985 年 1 月至 2004 年 12 月，回顾了 95 例年龄小于 20 岁的 NPC 患者的病历。所有病例均经活检病理证实。原发肿瘤的放射剂量为 64-80Gy。转移性颈淋巴结的放射剂量为 60-74Gy。分割剂量为每周 5 次，每次 1.8-2.0Gy。共有 36 例患者在放疗前接受化疗。
1、3、5、10 和 15 年的总生存率（OS）分别为 92.6%、63.2%、54.7%、46.8%和 42.6%。1、3、5、10 和 15 年无病生存率（DFS）分别为 73.7%、51.3%、49.1%、44.6%和 42.6%。临床分期对 OS（P=0.007）和 DFS（P=0.012）有显著影响。对治疗完全缓解的患者具有更好的 OS（P<0.001）和 DFS（P<0.001）。年龄>12 岁的患者 OS（P=0.026）和 DFS（P=0.037）更好。
患有晚期 NPC 的儿童和青少年具有相对较好的长期生存率。然而，28%的幸存者有严重的长期治疗相关的并发症。除了临床分期和完全缓解或部分缓解外，年龄也是儿科和青少年 NPC 的一个独立预后因素。
