Multimodal Treatment of Nasopharyngeal Carcinoma in Children, Adolescents and Young Adults-Extended Follow-Up of the NPC-2003-GPOH Study Cohort and Patients of the Interim Cohort
Tristan Römer, S. Franzen, Hanna Kravets, Ahmed Farrag, Anna Makowska, Hans Christiansen, Michael J. Eble, Beate Timmermann, Gundula Staatz, Felix M. Mottaghy, Martina Bührlen, Ulrich Hagenah, Alexander Puzik, Pablo Hernáiz Driever, Jeanette Greiner, Norbert Jorch, Stephan Tippelt, Dominik T. Schneider, Gabriele Kropshofer, Tobias R. Overbeck, Holger Christiansen, Triantafyllia Brozou, Gabriele Escherich, Martina Becker, Waltraud Friesenbichler, Tobias Feuchtinger, Wolfram Puppe, N Heussen, R.-D Hilgers, Udo Kontny
Abstract
Nasopharyngeal carcinoma (NPC) in children and young adults has been treated within two consecutive prospective trials in Germany, the NPC-91 and the NPC-2003 study of the German Society of Pediatric Oncology and Hematology (GPOH). In these studies, multimodal treatment with induction chemotherapy, followed by radio (chemo)therapy and interferon-beta maintenance, yielded promising survival rates even after adapting total radiation doses to tumor response. The outcome of 45 patients in the NPC-2003 study was reassessed after a median follow-up of 85 months. In addition, we analyzed 21 further patients after closure of the NPC-2003 study, recruited between 2011 and 2017, and treated as per the NPC-2003 study protocol. The EFS and OS of 66 patients with locoregionally advanced NPC were 93.6% and 96.7%, respectively, after a median follow-up of 73 months. Seven patients with CR after induction therapy received a reduced radiation dose of 54 Gy; none relapsed. In young patients with advanced locoregional NPC, excellent long-term survival rates can be achieved by multimodal treatment, including interferon-beta. Radiation doses may be reduced in patients with complete remission after induction chemotherapy and may limit radiogenic late effects.