| Wang Dongqing,Cao Xiujuan,Dong Wei,Yu Shui,Yang Xinhua,Hu Man,Zhai Limin.Efficacy of intensity-modulated radiotherapy combined with chemotherapy for nasopharyngeal carcinoma in children and adolescents[J].Chinese Journal of Radiological Medicine and Protection,2017,37(2):125-131 |
| Efficacy of intensity-modulated radiotherapy combined with chemotherapy for nasopharyngeal carcinoma in children and adolescents |
| Received:October 20, 2016 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.02.008 |
| KeyWords:Nasopharyngeal carcinoma Childhood Adolescents Radiotherapy |
| FundProject: |
| Author Name | Affiliation | E-mail | | Wang Dongqing | Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan 250117, China | | | Cao Xiujuan | Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan 250117, China | | | Dong Wei | Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan 250117, China | | | Yu Shui | Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan 250117, China | | | Yang Xinhua | Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan 250117, China | | | Hu Man | Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan 250117, China | | | Zhai Limin | Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan 250117, China | wdqlove2009@sina.com |
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| Abstract:: |
| Objective To evaluate the treatment outcomes and toxicities of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for children and adolescents with nasopharyngeal carcinoma.Methods Forty-three nasopharyngeal carcinoma patients less than 19 years old were recruited between April 2010 and April 2016. All patients were treated with IMRT (total dose 61.2-76 Gy) combined with cisplatin based chemotherapy. The Kaplan-Meier test was used to calculate overall survival (OS) and progression-free survival (PFS). The patient's clinical characteristics, side effects and long-term effects of treatment were retrospectively analyzed. Results Among 43 patients, there were 29 (67.4%) male and 14 (32.6%) female, and the median age was 14 years old (range, 6-18 years). According to AJCC 7th staging system, 2 patients were in stage Ⅱ, 26 in stage Ⅲ, 7 in stage ⅣA and 8 in stage ⅣB. All patients were confirmed as non-keratinizing carcinoma. The positive rates of EB virus VCA-IgA was 53.8% (7/13), and Rta-IgG was 60.0% (6/10) before treatment. The median radiation dose was 70 Gy (range, 61.2-76 Gy) to the primary tumor. Thirty-three (76.7%) patients received neoadjuvant chemotherapy, with 20 (46.5%) and 36 (83.7%) patients treated by concurrent and adjuvant chemotherapy, respectively. With a median follow-up of 24 months (range, 3-76 months), the 5-year OS and PFS ratios were 75.3% and 64.7%, respectively. There were 5 patients (11.6%) occured to bone metastasis within 2 years after treatment. Hypothyroidism was reported in 47.4% (9/19) patients after IMRT. Conclusions Nasopharyngeal carcinoma in childhood and adolescence is mostly locally advanced diseases with poor differentiation. IMRT combined with chemotherapy produce a well treatment outcome with good tolerance in children and adolescents patients. The most common treatment failure bone metastasis. Radiation-induced hypothyroidism is common. |
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