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Nasopharyngeal carcinoma in childhood and adolescence
Author(s) -
Mertens Rolf,
Granzen Bernd,
Lassay Lisa,
Gademann Günther,
Hess Clemens F.,
Heimann Gerhard
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970901)80:5<951::aid-cncr18>3.0.co;2-v
Subject(s) - medicine , nasopharyngeal carcinoma , carcinoma , radiation therapy
BACKGROUND The increasing use of chemotherapy has improved the prognosis of patients with nasopharyngeal carcinoma (NPC), and the authors demonstrated the beneficial effect of adjuvant interferon (IFN)‐β in a previous pilot study of children with advanced stage NPC. The current multi‐institutional, cooperative GPOH (Gesellschaft für Pädiatrische Onkologie und Hämatologie) study NPC‐91 was begun in 1992 to determine the efficacy of preradiation chemotherapy, radiotherapy, and adjuvant IFN‐β in the treatment of advanced stage NPC. METHODS Of a total of 22 patients, 21 had American Joint Committee on Cancer Stage III or IV disease, and 1 had Stage II disease. The median age was 12 years (range, 8‐16 years). Twenty of 22 received 3 courses of preradiation chemotherapy consisting of methotrexate 120 mg/m 2 on Day 1, cisplatin 100 mg/m 2 on Day 1, and 5‐fluorouracil 1000 mg/m 2 for five days as well as 6 doses of leucovorin 25 mg/m 2 every six hours beginning on Day 2. The Stage II patient received no chemotherapy, and chemotherapy was terminated for another during the first course. All patients had radiation therapy, stratified by stage. The cumulative dose to the primary sites was 59.4 gray (Gy), with single doses of 1.8 Gy. A total of 45 Gy was delivered to the neck area. Finally, all patients were treated with recombinant IFN‐β (10 5 U per kg of body weight) 3 times a week for 6 months. RESULTS The response rate was 91%. These patients stayed in first remission during a median follow‐up of 32 months. With the exception of one reversible cardiotoxicity, moderate chemotherapy‐related toxicity was observed. CONCLUSIONS In this study, patients with advanced stage NPC had a good prognosis with treatment consisting of neoadjuvant cisplatin and 5‐fluorouracil, radiotherapy, and adjuvant IFN‐β. It is particularly noteworthy that distant metastases did not develop. Cancer 1997; 80:951‐9. © 1997 American Cancer Society.