Objectives: To analyze the clinical outcome and prognostic factors of pediatric nasopharyngeal carcinomas, provide the basis for the rational treatment, and improve the cure rate.
Materials and methods: Thirty-two pediatric nasopharyngeal carcinoma patients with pathologically confirmed diagnosis and aged from 11 to 18 years old were retrospectively analyzed. All patients received intensity-modulated radiation therapy, dose of GTVnx 6400-7425 cGy, PGTVnx 6400-7050 cGy, PTV 15,400-6000 cGy, PTV 25,000-5490 cGy, and GTVnd 6000-6996 cGy were given. Among these patients, 29 received various chemotherapies. The Kaplan-Meier test and log-rank test of SPSS 17.0 statistic software package were used to calculate survival rate, compare and analyze the survival rates of each group. Cox model was used to analyzing the prognosis factors.
Results: In this study, the median survival time was 44.5 months, and the median follow-up time is 62.5 months. The 1-, 3-, and 5-year overall survival rates were 100.0%, 93.2%, 85.7%, respectively, in stage III, and 94.8%, 88.3%, and 64.7% in stage IV. All patients 1-, 3-, and 5-year overall survival rates were 97.2%, 90.5%, and 74.2%. Univariate analysis resulted that N stage (P = 0.043), chemotherapy (P = 0.003) and the radiotherapy dose (P = 0.028) were significant factors for survival. On multivariate analysis, only the N stage influence survival.
Conclusions: In pediatric nasopharyngeal carcinoma, the more important prognostic factors are N stage, chemotherapy, radiotherapy dose. Patients with N2-3 should be treated with combined chemotherapy and radiotherapy.