Prognostic factors and long-term outcomes of childhood nasopharyngeal carcinoma

Daniel Ka Leung Cheuk, Catherine A. Billups, Michael Martin, Cynthia R. Roland, Raul C. Ribeiro, Matthew J. Krasin, Carlos Rodriguez-Galindo

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: The authors studied the survival and long-term morbidities of children with nasopharyngeal carcinoma (NPC). METHODS: This was a retrospective review of children with NPC who were treated at St. Jude Children's Research Hospital between 1961 and 2004. Prognostic factors and long term effects of therapy were analyzed. RESULTS: Fifty-nine patients (median age, 14.1 years) were identified. Most were male (66.1%) and black (54.2%) and had lymphoepithelioma (93.2%). Thirty-five patients had stage IV disease (59.3%), 20 patients had stage III disease (33.9%), and 4 patients had stage II disease (6.8%). All patients received radiotherapy (RT) to the primary tumor, and most received cervical RT (98.3%) and chemotherapy (88.1%). The 15-year survival and event-free survival (EFS) rates were 67.2% ± 7.5% and 63.5% ± 7.8%, respectively. Five patients (8.5%) developed subsequent malignancies 8.6 to 27 years after NPC diagnosis. EFS was improved in patients who were diagnosed after 1980 (74.8% ± 10% vs 45.5% ± 10.1%; P =.031), in patients who had stage III disease compared with patients who had stage IV disease (79.3% ± 9.6% vs 56.2% ± 11.8%; P =.049), in patients who received cisplatin (81% ± 10.7% vs 45.8% ± 9.7%; P =.013), and in patients who received a≥50 grays of RT (71.4% ± 9.3% vs 43.8% ± 11.6%; P =.048). White patients had higher distant failure rates than black patients (41.7% ± 10.4% vs 15.6 ± 6.5%; P =.045). The 15-year cumulative incidence (CI) of any morbidity was 83.7% ± 5.4%, the CI of sensorineural hearing loss was 52.9% ± 6.7%, the CI of primary hypothyroidism was 42.7% ± 6.6%, and the CI of growth hormone deficiency (GHD) was 14.1% ± 4.7%. Dose-response relations were observed between the RT dose and primary hypothyroidism and GHD. CONCLUSIONS: The outcome of children with NPC improved over the past 4 decades with the use of cisplatin-based chemotherapy and higher RT doses. However, many survivors had long-term treatment-related morbidities.

Original languageEnglish (US)
Pages (from-to)197-206
Number of pages10
JournalCancer
Volume117
Issue number1
DOIs
StatePublished - Jan 1 2011

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Radiotherapy
Incidence
Hypothyroidism
Morbidity
Nasopharyngeal carcinoma
Cisplatin
Growth Hormone
Disease-Free Survival
Drug Therapy
Survival
Sensorineural Hearing Loss
Survivors
Neoplasms
Survival Rate
Therapeutics
Research

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Cheuk, D. K. L., Billups, C. A., Martin, M., Roland, C. R., Ribeiro, R. C., Krasin, M. J., & Rodriguez-Galindo, C. (2011). Prognostic factors and long-term outcomes of childhood nasopharyngeal carcinoma. Cancer, 117(1), 197-206. https://doi.org/10.1002/cncr.25376

Prognostic factors and long-term outcomes of childhood nasopharyngeal carcinoma. / Cheuk, Daniel Ka Leung; Billups, Catherine A.; Martin, Michael; Roland, Cynthia R.; Ribeiro, Raul C.; Krasin, Matthew J.; Rodriguez-Galindo, Carlos.

In: Cancer, Vol. 117, No. 1, 01.01.2011, p. 197-206.

Research output: Contribution to journalArticle

Cheuk, DKL, Billups, CA, Martin, M, Roland, CR, Ribeiro, RC, Krasin, MJ & Rodriguez-Galindo, C 2011, 'Prognostic factors and long-term outcomes of childhood nasopharyngeal carcinoma', Cancer, vol. 117, no. 1, pp. 197-206. https://doi.org/10.1002/cncr.25376
Cheuk DKL, Billups CA, Martin M, Roland CR, Ribeiro RC, Krasin MJ et al. Prognostic factors and long-term outcomes of childhood nasopharyngeal carcinoma. Cancer. 2011 Jan 1;117(1):197-206. https://doi.org/10.1002/cncr.25376
Cheuk, Daniel Ka Leung ; Billups, Catherine A. ; Martin, Michael ; Roland, Cynthia R. ; Ribeiro, Raul C. ; Krasin, Matthew J. ; Rodriguez-Galindo, Carlos. / Prognostic factors and long-term outcomes of childhood nasopharyngeal carcinoma. In: Cancer. 2011 ; Vol. 117, No. 1. pp. 197-206.
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abstract = "BACKGROUND: The authors studied the survival and long-term morbidities of children with nasopharyngeal carcinoma (NPC). METHODS: This was a retrospective review of children with NPC who were treated at St. Jude Children's Research Hospital between 1961 and 2004. Prognostic factors and long term effects of therapy were analyzed. RESULTS: Fifty-nine patients (median age, 14.1 years) were identified. Most were male (66.1{\%}) and black (54.2{\%}) and had lymphoepithelioma (93.2{\%}). Thirty-five patients had stage IV disease (59.3{\%}), 20 patients had stage III disease (33.9{\%}), and 4 patients had stage II disease (6.8{\%}). All patients received radiotherapy (RT) to the primary tumor, and most received cervical RT (98.3{\%}) and chemotherapy (88.1{\%}). The 15-year survival and event-free survival (EFS) rates were 67.2{\%} ± 7.5{\%} and 63.5{\%} ± 7.8{\%}, respectively. Five patients (8.5{\%}) developed subsequent malignancies 8.6 to 27 years after NPC diagnosis. EFS was improved in patients who were diagnosed after 1980 (74.8{\%} ± 10{\%} vs 45.5{\%} ± 10.1{\%}; P =.031), in patients who had stage III disease compared with patients who had stage IV disease (79.3{\%} ± 9.6{\%} vs 56.2{\%} ± 11.8{\%}; P =.049), in patients who received cisplatin (81{\%} ± 10.7{\%} vs 45.8{\%} ± 9.7{\%}; P =.013), and in patients who received a≥50 grays of RT (71.4{\%} ± 9.3{\%} vs 43.8{\%} ± 11.6{\%}; P =.048). White patients had higher distant failure rates than black patients (41.7{\%} ± 10.4{\%} vs 15.6 ± 6.5{\%}; P =.045). The 15-year cumulative incidence (CI) of any morbidity was 83.7{\%} ± 5.4{\%}, the CI of sensorineural hearing loss was 52.9{\%} ± 6.7{\%}, the CI of primary hypothyroidism was 42.7{\%} ± 6.6{\%}, and the CI of growth hormone deficiency (GHD) was 14.1{\%} ± 4.7{\%}. Dose-response relations were observed between the RT dose and primary hypothyroidism and GHD. CONCLUSIONS: The outcome of children with NPC improved over the past 4 decades with the use of cisplatin-based chemotherapy and higher RT doses. However, many survivors had long-term treatment-related morbidities.",
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AU - Krasin, Matthew J.

AU - Rodriguez-Galindo, Carlos

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N2 - BACKGROUND: The authors studied the survival and long-term morbidities of children with nasopharyngeal carcinoma (NPC). METHODS: This was a retrospective review of children with NPC who were treated at St. Jude Children's Research Hospital between 1961 and 2004. Prognostic factors and long term effects of therapy were analyzed. RESULTS: Fifty-nine patients (median age, 14.1 years) were identified. Most were male (66.1%) and black (54.2%) and had lymphoepithelioma (93.2%). Thirty-five patients had stage IV disease (59.3%), 20 patients had stage III disease (33.9%), and 4 patients had stage II disease (6.8%). All patients received radiotherapy (RT) to the primary tumor, and most received cervical RT (98.3%) and chemotherapy (88.1%). The 15-year survival and event-free survival (EFS) rates were 67.2% ± 7.5% and 63.5% ± 7.8%, respectively. Five patients (8.5%) developed subsequent malignancies 8.6 to 27 years after NPC diagnosis. EFS was improved in patients who were diagnosed after 1980 (74.8% ± 10% vs 45.5% ± 10.1%; P =.031), in patients who had stage III disease compared with patients who had stage IV disease (79.3% ± 9.6% vs 56.2% ± 11.8%; P =.049), in patients who received cisplatin (81% ± 10.7% vs 45.8% ± 9.7%; P =.013), and in patients who received a≥50 grays of RT (71.4% ± 9.3% vs 43.8% ± 11.6%; P =.048). White patients had higher distant failure rates than black patients (41.7% ± 10.4% vs 15.6 ± 6.5%; P =.045). The 15-year cumulative incidence (CI) of any morbidity was 83.7% ± 5.4%, the CI of sensorineural hearing loss was 52.9% ± 6.7%, the CI of primary hypothyroidism was 42.7% ± 6.6%, and the CI of growth hormone deficiency (GHD) was 14.1% ± 4.7%. Dose-response relations were observed between the RT dose and primary hypothyroidism and GHD. CONCLUSIONS: The outcome of children with NPC improved over the past 4 decades with the use of cisplatin-based chemotherapy and higher RT doses. However, many survivors had long-term treatment-related morbidities.

AB - BACKGROUND: The authors studied the survival and long-term morbidities of children with nasopharyngeal carcinoma (NPC). METHODS: This was a retrospective review of children with NPC who were treated at St. Jude Children's Research Hospital between 1961 and 2004. Prognostic factors and long term effects of therapy were analyzed. RESULTS: Fifty-nine patients (median age, 14.1 years) were identified. Most were male (66.1%) and black (54.2%) and had lymphoepithelioma (93.2%). Thirty-five patients had stage IV disease (59.3%), 20 patients had stage III disease (33.9%), and 4 patients had stage II disease (6.8%). All patients received radiotherapy (RT) to the primary tumor, and most received cervical RT (98.3%) and chemotherapy (88.1%). The 15-year survival and event-free survival (EFS) rates were 67.2% ± 7.5% and 63.5% ± 7.8%, respectively. Five patients (8.5%) developed subsequent malignancies 8.6 to 27 years after NPC diagnosis. EFS was improved in patients who were diagnosed after 1980 (74.8% ± 10% vs 45.5% ± 10.1%; P =.031), in patients who had stage III disease compared with patients who had stage IV disease (79.3% ± 9.6% vs 56.2% ± 11.8%; P =.049), in patients who received cisplatin (81% ± 10.7% vs 45.8% ± 9.7%; P =.013), and in patients who received a≥50 grays of RT (71.4% ± 9.3% vs 43.8% ± 11.6%; P =.048). White patients had higher distant failure rates than black patients (41.7% ± 10.4% vs 15.6 ± 6.5%; P =.045). The 15-year cumulative incidence (CI) of any morbidity was 83.7% ± 5.4%, the CI of sensorineural hearing loss was 52.9% ± 6.7%, the CI of primary hypothyroidism was 42.7% ± 6.6%, and the CI of growth hormone deficiency (GHD) was 14.1% ± 4.7%. Dose-response relations were observed between the RT dose and primary hypothyroidism and GHD. CONCLUSIONS: The outcome of children with NPC improved over the past 4 decades with the use of cisplatin-based chemotherapy and higher RT doses. However, many survivors had long-term treatment-related morbidities.

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