Abstract
Childhood Nasopharyngeal carcinoma (NPC) is a rare tumor among children, associated with Epstein–Barr virus infection andmore advanced disease at presentation, usually undifferentiated carcinoma. The distant failure is common observed among childhood NFC, which implies the need of early systemic treatment, but radiotherapy still is the main pillar of treatment. As the children are still growing organism, the cure of the patients is at the cost of late morbidity. The use of advanced radiotherapy techniques like IMRT (Intensity modulated radiotherapy) is beneficial for better sparing of surrounding organ at risk and reducing toxicity. Most common protocol used in European patients nowadays is NPC-2003- GPOH (German Pediatric Oncology Hematology Society), which has shown the best treatment results compared with other pediatric NPC study groups even with the strategy to deescalate the radiation dose in good responders to induction chemotherapy. However international randomize control trials are needed to answer when is safe to deescalate the radiation dose, could concomitant chemotherapy be omitted in case of good response of the induction chemotherapy, and is the maintenance therapy with interferon beta needed in all patients.
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