Nasopharyngeal Carcinoma Treatment in Children and Adolescents: Analysis of Outcomes in a Single Institution Cohort Treated with Risk-adapted Radiotherapy Dose

OBJECTIVENasopharyngeal cancer (NPC) in childhood is rare. In this study, we retrospectively report the results of adolescent and childhood NPC patients treated with different doses of intensity-modulated radiation therapy (IMRT) and 3D-conformal radiotherapy (RT) (3D-RT).METHODSBetween 2007 and 2020, 20 patients were included in our study, 18 of whom received induction chemotherapy before chemoradiotherapy (CRT) (n=16) or RT (n=2). High-risk planning target volumes of 61.2 Gy (complete or good partial response) and 63-70 Gy (partial response) included the primary tumor and metastatic lymph nodes. Survival analyses were made using the Kaplan-Meier method.RESULTSThe median follow-up time was 107 months (range: 6-168). The median age was 16 years (range 11-22). All patients had a complete response after CRT. The 5-year local control, disease-free survival, and overall survival were 100%. One patient developed distant metastasis (bone) at 62 months of treatment. There were no grade 4 acute side effects. Acute and late toxicity were observed lower in patients treated by dose reduction with IMRT.CONCLUSIONIn our study, over 60% of patients were treated with IMRT and dose reduction. Although lower-dose RT was administered, local-regional control was excellent, and the incidence rate of side effects was low.