Nasopharyngeal carcinoma in children under 15 years of age: A retrospective review of 65 patients

Background: Nasopharyngeal carcinoma constitutescomprises up to 5% of primary childhood cancers but literature lacks modern uniformly treated large series.Patients and methods: A retrospective review was performed of sixty-five previously untreated patients younger than 16 years of age diagnosed and treated at the Ibn Rochd Centre in Casablanca between 1988 and 1992. Forty-four percent of them were stage T₃ to T₄ and 66% stage N₂ or N₃. All patients were irradiated. Prior adjuvant chemotherapy was administered in 33 patients. Thirteen patients were lost to follow-up.Results: Local control was obtained in 85% of the 52 evaluable patients. The five-year overall survival was 42% and disease-free survival 38%. Ten relapses occurred at local and/or regional sites. Six patients have distant metastases. All 24 patients with relapse or persistent disease died despite salvage therapy. Stage, histology and dose of radiation, were statistically significant prognostic variables. Patients treated with chemotherapy followed by irradiation had a better outcome than those treated with radiation alone.Conclusions: Nasopharyngeal carcinoma in children is a rare chemosensitive tumor. However, conclusive treatment guidelines cannot be drawn from this series and prospective co-operative studies are needed for the development of more effective and less toxic therapeutic strategies.