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Comparison of long-term outcomes and sequelae between children and adult nasopharyngeal carcinoma treated with intensity-modulated radiotherapy.
Artigo em Inglês | MEDLINE | ID: mdl-31794839
ABSTRACT

PURPOSE:

To compare long-term survival outcomes and sequelae between children and adult nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiotherapy (IMRT).

METHODS AND MATERIALS:

Data on 285 NPC patients aged ≤ 18 years old at diagnosis and treated with IMRT between January 2004 and November 2016 were retrospectively reviewed. Propensity score matching method was adopted to screen matched adult NPC patients at a ratio of 1:3. Survival outcomes and treatment-related toxicities between children and adult groups were compared.

RESULTS:

In total, 159 children and 477 adult NPC patients were included in this study. The 5-year overall survival (OS), distant metastasis-free survival (DMFS), locoregional relapse-free survival (LRRFS), and disease-free survival (DFS) between children and adult were 89.2% vs 83.6% (P = 0.144), 88.7% vs 83.5% (P = 0.124), 96.4% vs 89.1% (P = 0.013), and 86.5% vs 77.3% (P = 0.021), respectively. Subgroup analyses revealed that the young age was an independent prognostic factor of OS, DMFS and LRRFS in advanced N stage (N2-3) group, and DFS in advanced T stage (T3-4) group, N2-3 and stage III-IVA groups. The most common sequela was ototoxicity (68.9%) in children patients and xerostomia (70.8%) in adult patients. Adult survivors had a significantly higher incidence of grade 3-4 late toxicities in xerostomia (17.6% vs. 8.9%, P = 0.004), skin dystrophy (9.3% vs. 3.7%, P = 0.022), neck fibrosis (8.3% vs. 4.4%, P < 0.001) and radiation encephalopathy (0.8% vs. 0, P = 0.006). Children survivors were more likely to develop grade 3-4 growth retardation and endocrine insufficiency (3.0% vs. 0.3%, P = 0.014).

CONCLUSIONS:

Children NPC patients achieved significantly better survival outcomes but less late toxicities than adult patients. However, we should pay great attention to growth problems of children survivors.

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Aspecto clínico: Prognóstico Idioma: Inglês Ano de publicação: 2019 Tipo de documento: Artigo