Bhanuprasad V, Mallick Supriya, Bhasker Suman, Mohanti Bidhu Kalyan
Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Int J Pediatr Otorhinolaryngol. 2015 Aug;79(8):1279-82. doi: 10.1016/j.ijporl.2015.05.031. Epub 2015 May 30.
Head and neck carcinoma is a very rare entity in pediatric age group. We here present the demography, treatment and outcome of 12 pediatric patients.
We retrieved the treatment charts of pediatric patients with a diagnosis of head and neck squamous cell carcinoma (PHNSCC). We also retrieved the published literature of pediatric HNSCC to present the treatment modalities being delivered across institutes.
We found 12 patients registered with a diagnosis of squamous cell carcinoma. Median age of the entire cohort was 17 years (Range: 8-20). Gender predilection was skewed in favor of male (male:female ratio-11:1). Oral tongue 3(25%) was the commonest sub site followed by soft palate 2(17%) gingiva 2 (17%), supra glottis larynx 2(17%) and one each of hard palate, buccal mucosa, floor of mouth (8.25% each). The most commonly employed modality of treatment was surgery in 6(50%). Radiation was used in seven cases: 7(Adjuvant-4, Radical-3). Two patients received radical chemo-radiation. Neo-adjuvant chemotherapy was used in two cases. Median follow up duration was 2 years (Range: 6 months to 8 years). One patient recurred 6 months post completion of radical chemo-radiation. The patient with recurrent disease had soft palate primary and had isolated local recurrence. The patient was salvaged with surgery and was disease free at the last follow up. At the last follow up all patients were surviving without disease.
The treatment and survival are not much different in pediatric patients compared to adult counterpart. However, in the absence of molecular profiling it is difficult to assess the cause of development of SCC in pediatric patients. A detailed study of underlying molecular pathway will further guide the future treatment.
头颈癌在儿童年龄组中是一种非常罕见的疾病。我们在此介绍12例儿科患者的人口统计学、治疗情况及结果。
我们检索了诊断为头颈部鳞状细胞癌（PHNSCC）的儿科患者的治疗记录。我们还检索了已发表的儿科HNSCC文献，以展示各机构所采用的治疗方式。
我们发现12例诊断为鳞状细胞癌的患者。整个队列的中位年龄为17岁（范围：8 - 20岁）。性别倾向于男性（男：女比例为11：1）。口腔舌部3例（25%）是最常见的亚部位，其次是软腭2例（17%）、牙龈2例（17%）、声门上喉2例（17%），硬腭、颊黏膜、口腔底部各1例（各占8.25%）。最常用的治疗方式是手术，共6例（50%）。7例使用了放疗：7例（辅助放疗4例，根治性放疗3例）。2例患者接受了根治性放化疗。2例使用了新辅助化疗。中位随访时间为2年（范围：6个月至8年）。1例患者在根治性放化疗完成后6个月复发。复发患者原发于软腭，仅有局部复发。该患者通过手术挽救，最后一次随访时无疾病。在最后一次随访时，所有患者均无病存活。
与成年患者相比儿科患者的治疗和生存率没有太大差异。然而，在缺乏分子谱分析的情况下，很难评估儿科患者鳞状细胞癌发生的原因。对潜在分子途径的详细研究将进一步指导未来的治疗。
