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Treatment Results Of 165 Pedıatrıc Patıents Wıth Non-Metastatıc Nasopharyngeal Carcınoma: A Rare Cancer Network StudyUzel Ö., Akman F., Ozyar E., Selek U., Laskar S., Anacak Y., Arush B.A., Polychronopoulou S., Wolden S., Sarıhan S., Miller R., Özsahin M., Abacıoğlu U., Martin M., Caloglu M.Purpose: This study was performed retrospectively in pediatric (age < or = 17 years) NPC patients to evaluate the possible prognostic factors.Material and Methods: The study included 165 (109 male and 56 female) pediatric patients with the diagnosis of non-metastatic NPC treated between 1978 and 2003 from 16 centers collaborating in the Rare Cancer Network.. The median age is 14 years old. Histopathological classification revealed 23 (13.9%) patients with WHO II and 142 (86.1%) patients with WHO III. There were 3 (1.8%) patient with stage I, 1 (0.6%) with IIa, 10 (6.1%) with IIb, 60 (36.4%) with III, 44 (26.7%) with IVA, and 47 (29%) with IVB. All patients were treated beam radiotherapy (EBRT) to a median dose of 66 Gy. Chemotherapy schedule was non-cisplatin based mono therapy in 1 (0.8%), cisplatin based mono therapy in 10 (6.9%), non-cisplatin based multi regimen in 29 (20.1%) and cisplatin based multi regimen in 104 (72.2%) patients. The median follow-up time was 48 months. Results: The actuarial overall 5-year survival (OS) was 77.4%, whereas the actuarial 5-year local relapse free survival (LRFS), loco-regional relapse free survival (LRRFS), distant metastasis-free survival (DMFS) and disease-free survival (DFS) rates were 87.8%, 81.9%, 80.5% and 68.8%, respectively. In multivariate analysis, unfavourable factors were age older than 14 years for LRC (p=0.04); male gender for DMFS (p=0.03); T3,T4 disease for LRFS (p=0.01); N3 disease for DFS (p=0.002) and OS (p=0.002); total nasopharyngeal EBRT dose of less than 66 Gy for LRFS (p=0.02) and LRRFS (p=0.002); and patients treated with radiotherapy alone for LRFS (p=0.0001), LRRFS (p=0.007) and DFS (p=0.02). Conclusion: This data suggests that high dose RT combined with multiagent chemotherapy is effective in achieving satisfactory results.
Türk Otorinolarengoloji XXVIII.Ulusal Kongresi Özetleri S125
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