Treatment of nasopharyngeal carcinoma in children and adolescents

Definitive results of a multicenter study (NPC-91-GPOH)

Authors


  • 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).

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

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