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A prospective protocol for nasopharyngeal carcinoma in children and adolescents: the Italian Rare Tumors in Pediatric Age (TREP) project
A prospective protocol for nasopharyngeal carcinoma in children and adolescents: the Italian Rare Tumors in Pediatric Age (TREP) project
- Source :
- Cancer. 118(10)
- Publication Year :
- 2011
-
Abstract
- BACKGROUND: Nasopharyngeal carcinoma (NPC) is very rare in childhood. It differs from its adult counterpart in the prevalence of the nonkeratinizing, undifferentiated subtype and by an advanced clinical stage at onset and better chances of survival. The risk of long-term treatment-related toxicity also may be a more important issue in younger individuals. METHODS: A prospective chemoradiotherapy protocol for pediatric NPC was started in Italy in 2000 within the framework of the Rare Tumors in Pediatric Age (TREP) project. Three courses of cisplatin/5-fluorouracil induction chemotherapy were followed by radiotherapy (doses up to 65 grays) with concomitant cisplatin. RESULTS: Forty-six patients (ages 9-17 years) were considered eligible for the study over a 10-year period. The ratio of observed to expected cases based on epidemiological data was approximately 1 for both children and adolescents. All but 1 patient had lymph node involvement, and 5 patients had distant metastases. The rate of response to primary chemotherapy was 90%. The 5-year overall and progression-free survival rates were 80.9% and 79.3%, respectively (median follow-up, 62 months). The only statistically significant prognostic variable was the presence or absence of distant metastases. A 65% incidence of late sequelae was reported. CONCLUSIONS: This study demonstrates the feasibility and efficacy of a prospective protocol even for such rare tumors as pediatric NPC. The use of lower radiotherapy doses than those used in adults did not affect locoregional failure rates. Long-term follow-up will be needed to obtain more information on both survival and treatment sequelae. The next objective will be to establish broader, international prospective cooperation schemes. Cancer 2011. © 2011 American Cancer Society.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
Prognostic variable
Pediatrics
Herpesvirus 4, Human
Adolescent
Disease-Free Survival
medicine
Carcinoma
Humans
Prospective Studies
Prospective cohort study
Child
Neoplasm Staging
Nasopharyngeal Carcinoma
business.industry
Incidence (epidemiology)
Cancer
Induction chemotherapy
Nasopharyngeal Neoplasms
Chemoradiotherapy
medicine.disease
Surgery
Treatment Outcome
Oncology
Nasopharyngeal carcinoma
DNA, Viral
Female
business
Subjects
Details
- ISSN :
- 10970142
- Volume :
- 118
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....82e9683e6106d2bf0bc491da0f5aea05