Childhood nasopharyngeal carcinoma.

A retrospective analysis identified 40 children and adolescents with nasopharyngeal carcinoma who were evaluated and treated at the Medical Center of Louisiana from 1948 through 1992. The male to female ratio was 1.8:1. Thirty-two patients had lymphoepithelioma and 8 had squamous cell carcinoma. Twenty-three children had primary lesions confined to the nasopharynx. In 8 patients, the tumor extended into the nasal cavity or oropharynx, and 7 patients had tumor invasion of skull or cranial nerve. Thirty-one had palpable cervical lymphadenopathy. There were no documented distant metastasis at presentation. All patients were treated with primary radiotherapy, and 9 patients also had chemotherapy containing cisplatin, fluorouracil, bleomycin, cyclophosphamide, and doxorubicin. Ten are alive 5 to 30 years from time of diagnosis (median 10 years). Distant metastasis was the initial cause of failure. Though not a controlled study, bias in the data insinuate an improved prognosis for male patients, age > 10 years, tumor limited to the nasopharynx without extension (T1-2), absence or single positive homolateral node (N0-1), and patients who received chemotherapy.