Aims: Nasopharyngeal carcinoma (NPC) is rare in young patients. The aim of this study was to provide an analysis of 42 patients under 20 years of age with locoregional disease treated in a single institution.
Materials and methods: Forty-two NPC patients aged <or=20 years (median age 16 years) represented only 2.3% of all NPC cases treated in our department between 2000 and 2003. Of these patients, 14 were stage II, 21 stage III, and seven stage IV, as diagnosed according to the 1997 American Joint Committee on Cancer (AJCC) staging system. Seventeen patients received radiotherapy alone and 25 had cisplatin-based chemotherapy additionally. The radiation dose to the primary tumour and involved nodes was 64-74 Gy.
Results: After a median follow-up of 60 months, the 5-year locoregional control, overall survival and disease-free survival rates were 87, 79 and 73%, respectively. More than 50% of the relapses (6/11) were distant metastases. Patients with N0-1 had a lower distant metastasis rate compared with patients with N2-3, and the TNM stage grouping was found to be a marginally important prognostic factor for disease-free survival. The addition of chemotherapy failed to be of therapeutic value. Acute and chronic toxicities were limited, consisting primarily of mucositis and xerostomia.
Conclusions: The outcome of the present series was excellent, and matched well with other publications. A high systemic failure remains a major obstacle to cure young NPC patients. More efforts should be made to improve both survival and quality of life.