- Induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) results in excellent outcomes for pediatric patients with advanced nasopharyngeal cancer (NPC).
- Radiation dose reduction is feasible for patients who respond to IC.
Why this matters
- Treatments for childhood NPC are adapted from adult regimens because pediatric-specific studies are limited, say researchers.
- All outcome endpoints, including event-free survival (EFS), OS, and locoregional and distant control, appear superior to those reported in adults.
- Researchers studied pediatric patients with stage IIb-IV NPC (n=111; median age, 15 [range, 3-18] years; boys, 68%) treated with 3 cycles of IC with cisplatin and fluorouracil followed by CCRT with 2 or 3 cycles of cisplatin.
- Children with complete/partial response to IC received 61.2 Gy to the nasopharynx and neck; those with stable disease received 71.2 Gy.
- Funding: National Institutes of Health; St. Baldrick’s Foundation.
- 5-year EFS and OS estimates were 84.3% and 89.2%, respectively.
- 5-year EFS for stages IIb, III, and IV was 100%, 82.8%, and 82.7%, respectively.
- 5-year cumulative incidence relapse estimates were 3.7% (local), 8.7% (distant), and 1.8% (combined).
- Patients had better 5-year postinduction PFS when treated with 3 CCRT cycles (90.8%) vs 2 (81.1%; P=.14).
- Absence of control group.
- Long-term toxicity not captured.