P0171 Endemic undifferentiated nasopharyngeal carcinoma in algerian children and teenagers

Abstract

Background Undifferentiated nasopharyngeal carcinoma is an endemic disease in some regions in the world, such as south east Asia, around the Mediterranean, and in Alaska. Methods We did a retrospective study of nasopharyngeal carcinoma in children and teenagers treated in our centre between 2000 and 2013. Findings Nasopharyngeal carcinoma represented 10% of all cancers and 41.1% of head and neck cancers among the 1458 patients registered at our centre. The sex ratio was 2.1 and average age was 44 years. Undifferentiated carcinoma represented 88.9% and differentiated carcinoma 6.2% of cases. Patients under 20 years represented 13.2% of cases, with a sex ratio of 1.5 and average age of 17 years. The average time for diagnosis was 6.9 months, undifferentiated carcinoma was found in 97% and differentiated carcinoma in 3% of cases. At the diagnosis, patients presented with the following symptoms: lymph nodes 75.7%, rhinological 64.0%, otological 55.3%, neurological 54.3%, and ophthalmological 5.8%. 70% of cases were stage IV, 11.6% stage III, 8.7% stage II, and 0.9% stage I. Metastases were found in 12.6% (10.7% in bone and 0.9% in lung). Neoadjuvant chemotherapy was indicated in 88.3% of patients with the average 3.6 month course. This chemotherapy was based on the combination of platinum and other drugs in 94%, the schedule most used was doxorubicin/CDDP in 71.8% of cases. After chemotherapy, complete response was noted in 23.3%, partial response in 43.3%, and progression in 10.0%; 23.3% died. Only 45.6% received external radiotherapy. 33.9% of patients received a second line of chemotherapy because of recurrent disease (16.5%) or metastases (16.5%). 36.9% were in complete remission after their combined treatment and 20.8% never returned to our centre. Overall survival could not be calculated. Interpretation Undifferentiated nasopharyngeal carcinoma is an aggressive and endemic subtype of head and neck cancer in Algeria that affects children too; it is diagnosed late because of its rapid onset but responds well to chemoradiotherapy and has a good prognosis. Diagnosed earlier and managed well with chemoradiotherapy, it can be completely cured. Undifferentiated nasopharyngeal carcinoma is an endemic disease in some regions in the world, such as south east Asia, around the Mediterranean, and in Alaska. We did a retrospective study of nasopharyngeal carcinoma in children and teenagers treated in our centre between 2000 and 2013. Nasopharyngeal carcinoma represented 10% of all cancers and 41.1% of head and neck cancers among the 1458 patients registered at our centre. The sex ratio was 2.1 and average age was 44 years. Undifferentiated carcinoma represented 88.9% and differentiated carcinoma 6.2% of cases. Patients under 20 years represented 13.2% of cases, with a sex ratio of 1.5 and average age of 17 years. The average time for diagnosis was 6.9 months, undifferentiated carcinoma was found in 97% and differentiated carcinoma in 3% of cases. At the diagnosis, patients presented with the following symptoms: lymph nodes 75.7%, rhinological 64.0%, otological 55.3%, neurological 54.3%, and ophthalmological 5.8%. 70% of cases were stage IV, 11.6% stage III, 8.7% stage II, and 0.9% stage I. Metastases were found in 12.6% (10.7% in bone and 0.9% in lung). Neoadjuvant chemotherapy was indicated in 88.3% of patients with the average 3.6 month course. This chemotherapy was based on the combination of platinum and other drugs in 94%, the schedule most used was doxorubicin/CDDP in 71.8% of cases. After chemotherapy, complete response was noted in 23.3%, partial response in 43.3%, and progression in 10.0%; 23.3% died. Only 45.6% received external radiotherapy. 33.9% of patients received a second line of chemotherapy because of recurrent disease (16.5%) or metastases (16.5%). 36.9% were in complete remission after their combined treatment and 20.8% never returned to our centre. Overall survival could not be calculated. Undifferentiated nasopharyngeal carcinoma is an aggressive and endemic subtype of head and neck cancer in Algeria that affects children too; it is diagnosed late because of its rapid onset but responds well to chemoradiotherapy and has a good prognosis. Diagnosed earlier and managed well with chemoradiotherapy, it can be completely cured.