Improved long-term survival with combined modality therapy for pediatric nasopharynx cancer Journal Article
| Authors: | Wolden, S. L.; Steinherz, P. G.; Kraus, D. H.; Zelefsky, M. J.; Pfister, D. G.; Wollner, N. |
| Article Title: | Improved long-term survival with combined modality therapy for pediatric nasopharynx cancer |
| Abstract: | Purpose: Nasopharynx cancer is a rare malignancy in childhood. This study aims to determine the role of chemotherapy, the optimal dose of radiation, and the long-term outcome for children with locoregional disease. Methods and Materials: Thirty-three patients [median age 14 (range: 12-20) years] were treated for Stage I-IVB nasopharynx cancer. Thirteen patients (39%) received radiotherapy alone and 20 patients (61%) had chemotherapy and radiotherapy. The median radiation dose to the primary tumor was 66 Gy (range: 54-72 Gy). The median follow-up time for surviving patients was 8.4 years (range: 0.5-23.6 years). Results: The actuarial 10-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates were 77%, 68%, and 58%, respectively. Locoregional control was improved for patients treated with radiation doses >60 Gy compared to those receiving ≤60 Gy (93% vs. 60%, p < 0.03). The addition of chemotherapy had no significant effect on locoregional control but did reduce the development of distant metastases (16% vs. 57%, p = 0.01). Combined modality therapy improved 10-year disease-free survival (84% vs. 35%, p < 0.01) and survival (78% vs. 33%, p < 0.05) over radiation alone. The 10-year actuarial rate of severe complications was 24%. Conclusions: Excellent locoregional control is achieved with radiotherapy to the nasopharynx and neck when doses >60 Gy are used for gross disease. The addition of chemotherapy decreases the risk of distant metastases and increases survival. Copyright (C) 2000 Elsevier Science Inc. |
| Keywords: | adolescent; adult; cancer survival; child; clinical article; controlled study; disease-free survival; survival rate; retrospective studies; carcinoma, squamous cell; cisplatin; doxorubicin; fluorouracil; multimodality cancer therapy; antineoplastic agents; cancer radiotherapy; combined modality therapy; chemotherapy; methotrexate; follow-up studies; radiation; radiotherapy dosage; radiotherapy; vincristine; pediatric; carcinoma; dactinomycin; bleomycin; neoplasms, second primary; nasopharynx cancer; nasopharyngeal neoplasms; nasopharynx; cancer; humans; human; male; female; priority journal; article |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 46 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2000-03-01 |
| Start Page: | 859 |
| End Page: | 864 |
| Language: | English |
| DOI: | 10.1016/s0360-3016(99)00493-9 |
| PUBMED: | 10705006 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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