Nasopharyngeal Carcinoma Treatment in Children and Adolescents: Analysis of Outcomes in a Single Institution Cohort Treated with Risk-adapted Radiotherapy Dose
Meltem DAĞDELEN1,Süheyla OCAK2,Tuba KURT ÇATAL1,Songül ÇAVDAR KARAÇAM1,Emine Sedef AKOVALI3,Sevda KANAT1,Muhammed Veysel HEKIM1,Ömer Erol UZEL1
1Department of Radiation Oncology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Türkiye
2Department of Pediatric Hematology and Oncology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul- Türkiye
3Department of Radiation Oncology, Sakarya Regional Training and Research Hospital, Sakarya-Türkiye
DOI : 10.5505/tjo.2023.4162 OBJECTIVE
Nasopharyngeal cancer (NPC) in childhood is rare. In this study, we retrospectively report the results of adolescent and childhood NPC patients treated with different doses of intensity-modulated radiation therapy (IMRT) and 3D-conformal radiotherapy (RT) (3D-RT).

Between 2007 and 2020, 20 patients were included in our study, 18 of whom received induction chemotherapy before chemoradiotherapy (CRT) (n=16) or RT (n=2). High-risk planning target volumes of 61.2 Gy (complete or good partial response) and 63?70 Gy (partial response) included the primary tumor and metastatic lymph nodes. Survival analyses were made using the Kaplan?Meier method.

The median follow-up time was 107 months (range: 6?168). The median age was 16 years (range 11?22). All patients had a complete response after CRT. The 5-year local control, disease-free survival, and overall survival were 100%. One patient developed distant metastasis (bone) at 62 months of treatment. There were no grade 4 acute side effects. Acute and late toxicity were observed lower in patients treated by dose reduction with IMRT.

In our study, over 60% of patients were treated with IMRT and dose reduction. Although lower-dose RT was administered, local-regional control was excellent, and the incidence rate of side effects was low. Keywords : Chemotherapy; children and adolescents; nasopharyngeal carcinoma; radiotherapy