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Treatment of nasopharyngeal carcinoma in children and adolescents†
Definitive results of a multicenter study (NPC-91-GPOH)
Article first published online: 5 JUL 2005
Copyright © 2005 American Cancer Society
Volume 104, Issue 5, pages 1083–1089, 1 September 2005
How to Cite
Mertens, R., Granzen, B., Lassay, L., Bucsky, P., Hundgen, M., Stetter, G., Heimann, G., Weiss, C., Hess, C. F. and Gademann, G. (2005), Treatment of nasopharyngeal carcinoma in children and adolescents. Cancer, 104: 1083–1089. doi: 10.1002/cncr.21258
These participating institutions recruited patients into the study and are listed in alphabetical order. The number of patients recruited appears after each researcher's name. Departments of Pediatric Hematology and Oncology 1 and Departments of Radio-oncology 2, University of Aachen (Mertens R. 1, Eble, M. 2); University of Berlin (Henze G.1, Wurm D. 2); University of Bonn (Bode U. 1, Schüller M. H.2); University of Bremen (Spaar J. 1, Habermalz M. 2); Children's Hospital Datteln, St.Vincenz-Hospital (Andler W. 1, Langrock J. 2); University of Dusseldorf (Gobel U. 1, Schmitt G. 2); University of Essen (Havers W. 1, Streffer Ch. 2); University of Erfurt (Weinmann G.1, Glaser F.H.2); University of Freiburg (Niemeyer C. 1, Frommhold H. 2); University of Gottingen (Lakomek M. 1, Hess C. F. 2); University of Giessen (Reiter A. 1, Lieven von, H. 2); Children's Hospital Gummersbach (Gerein V. 1, Adamietz, I. 2); University of Heidelberg (Selle B. 1, Wannemacher M. 2); University of Homburg (Graf N. 1, Leetz K-H. 2); University of Munster (Jurgens H. 1 Rübe M. 2); Children's Hospital Krefeld (Kosenow H. 1, Reifenberger G.2); University of Magdeburg (Siebertz Th. 1, Gademann G. 2); University of Marburg (Rieger C. 1, Christiansen, J. 2); University of Munchen (Muller-Weihrich St. 1, Stephan R. 2); University of Munchen (Bender-Gotze Ch. 1, Duhmke E. 2); Children-s Hospital Nurnberg (Tietze J. 1, Renner H. 2); Children's Hospital Saarbrucken (Geib R. 1, Jacobs H. 2); Children-s Hospital Stuttgart (Treuner J. 1, Winkler C.2); Children's Hospital Trier (Rauh, W. 1, Dornhoff W. 2); University of Tubingen (Niethammer D.1, Bamberg M.2); Children's Hospital Wolfsburg (Langelitis G.1, Brodazeck K. 2); University of Innsbruck, Osterreich (Fink K. 1, Lukas P. 2); University of Wien, Osterreich (Gadner, H 1, Potter, G.2); University of Amsterdam (Zwaan C..M. 1, Metha, D. M. 2); University of Luttich (Hoyoux C. 1, Gritten, CH. 2); University of Nijmegen (Bokkerink J.P.M. 1, van Daal W. 2); University of Maastricht (Granzen B. 1, van den Enden P.2).
- Issue published online: 17 AUG 2005
- Article first published online: 5 JUL 2005
- Manuscript Accepted: 25 APR 2005
- Manuscript Revised: 31 MAR 2005
- Manuscript Received: 19 OCT 2004
- Forderkreis Hilfe fur krebskranke Kinder e. V. Aachen
- Society for Pediatric Oncology and Hematology (GPOH)
- nasopharyngeal carcinoma;
- radiation therapy;
- interferon beta
Preliminary results of combined neoadjuvant chemotherapy, radiotherapy, and postradiation interferon beta (IFN-β) in children and adolescents with nasopharyngeal carcinoma, especially in high-risk patients, have been promising.
From 1992 to 2003, 59 patients (58 high-risk patients and 1 low-risk patient, median age 13 yrs; range, 8–25 yrs) were treated in the GPOH-NPC-91 study. The Stage II patient received irradiation as initial therapy. Fifty-eight patients received preradiation chemotherapy with methotrexate, cisplatin, and 5-fluorouracil. The cumulative radiation dose to primary sites was 59.4 Gy, a total dose of 45 Gy was delivered to the neck area. After irradiation, all patients were treated with 105 U recombinant IFN-β/kg body weight 3 times a week for 6 months.
After combination therapy, complete response was accomplished in 58 patients. In one patient, there was tumor progression during chemotherapy. In 3 patients, distant metastases were observed 14, 15, and 18 months after diagnosis, respectively. One patient had a local relapse 12 months after diagnosis. Fifty-four patients are still in first remission with a median follow-up of 48 months (range, 10–110 mos). Chemotherapy-related toxicity was mucositis Grade II, III, or IV in all patients and acute cardiotoxicity in 2 (3.5%) of the patients. Nephrotoxicity Grade I–II occurred in 8.8% of patients.
The combination of initial chemotherapy, radiotherapy, and IFN-β results in an excellent outcome. These results strongly support the development of a future treatment strategy along this line. Cancer 2005. © 2005 American Cancer Society.