Asia-Pacific Journal of Clinical Oncology

Original article

Does primary tumor volume predict the outcome of pediatric nasopharyngeal carcinoma?: A prospective single-arm study using neoadjuvant chemotherapy and concomitant chemotherapy with intensity modulated radiotherapy

Corresponding Author

Mohamed S. Zaghloul

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

Correspondence: Mohamed S. Zaghloul, MD, Children's Cancer Hospital, Egypt & National Cancer Institute, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Egypt. Email: [email protected]Search for more papers by this author

Eman Eldebawy,

Eman Eldebawy

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Soha Ahmed,

Soha Ahmed

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hany Ammar,

Hany Ammar

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Ehab Khalil,

Ehab Khalil

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hany Abdelrahman,

Hany Abdelrahman

Pediatric Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Wael Zekri,

Wael Zekri

Pediatric Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hosam Elzomor,

Hosam Elzomor

Pediatric Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hala Taha,

Hala Taha

Pathology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Amr Elnashar,

Amr Elnashar

Research Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Mohamed S. Zaghloul,

Corresponding Author

Mohamed S. Zaghloul

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

Eman Eldebawy,

Eman Eldebawy

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Soha Ahmed,

Soha Ahmed

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hany Ammar,

Hany Ammar

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Ehab Khalil,

Ehab Khalil

Radiation Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hany Abdelrahman,

Hany Abdelrahman

Pediatric Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Wael Zekri,

Wael Zekri

Pediatric Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hosam Elzomor,

Hosam Elzomor

Pediatric Oncology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Hala Taha,

Hala Taha

Pathology Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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Amr Elnashar,

Amr Elnashar

Research Departments, Children's Cancer Hospital, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt

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First published: 24 February 2016

https://doi.org/10.1111/ajco.12460

Citations: 10

Conflict of interest: none

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Abstract

Background

Nasopharyngeal carcinoma is rare in children and adolescents; however, it has a better prognosis than in adults. Nevertheless, its prognostic factors are not clearly documented.

Patients and methods

A prospective single-arm study was performed in 32 nonmetastatic Stages II–IV nasopharyngeal carcinoma (NPC) patients, below age 18 years. The treatment regimen included three courses of neoadjuvant chemotherapy (cisplatin and fluorouracil) followed by concomitant chemoradiotherapy (simultaneous integrated boost-intensity modulated radiotherapy [SIB-IMRT] with three cycles of cisplatin).

Results

All patients completed their prescribed treatment with tolerable acute side-effects. The 3-year overall (OS), event-free (EFS), local recurrence-free (LRFS), and distant metastasis-free (DMFS) survival rates were 83 ± 8, 77 ± 8, 92 ± 6 and 77 ± 9 percent, respectively. Although the median initial (pretreatment) gross tumor volume of the primary site (GTVp) increased with increasing stage, yet these differences did not rank to the level of significance. However, GTVp (with a cut-off value of 54.5 mL) was the only significant prognostic factor determining OS, EFS, LRFS and DMFS. On the other hand, age, gender, T stage, AJCC stage and footprint histopathological EBV did not have statistical significant impact on any survival rate. The late toxicity of this regimen was much lower than that reported with the conformal treatment.

Conclusion

Neoadjuvant chemotherapy and concomitant chemo-radiotherapy using SIB-IMRT led to excellent outcome with reduced late toxicity in juvenile nasopharyngeal carcinoma. GTVp is the sole prognostic factor that showed statistical impact on survival rates when applying this regimen.

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Volume12, Issue2

June 2016

Pages 143-150

Does primary tumor volume predict the outcome of pediatric nasopharyngeal carcinoma?: A prospective single-arm study using neoadjuvant chemotherapy and concomitant chemotherapy with intensity modulated radiotherapy

Abstract

Background

Patients and methods

Results

Conclusion

REFERENCES

Citing Literature

References

Information

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Does primary tumor volume predict the outcome of pediatric nasopharyngeal carcinoma?: A prospective single-arm study using neoadjuvant chemotherapy and concomitant chemotherapy with intensity modulated radiotherapy

Abstract

Background

Patients and methods

Results

Conclusion

REFERENCES

Citing Literature

References

Related

Information