Journal of Medical and Surgical
Research (JMSR)


Pages: 863-869DOI: 10.46327/msrjg.1.000000000000183

Date of Publication: 30-Nov--0001

Undifferentiated Nasopharyngeal Carcinoma in Children and Adolescents : A Report of 68 Cases in a Moroccan Center

Author: Siham Jaba, Patricia Agbanglanon, Wilfried Bassané Alain Mossé, Gaël Kietga, Hanan Elkacemi, Sanae Elmajjaoui, Tayeb Kebdani, Noureddine Benjaafar

Category: JMSR Oncology

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This study aimed to demonstrate the clinical and therapeutic features of nasopharyngeal carcinoma (NPC) in children and adolescents in Morocco, an intermediate risk area. A total of 68 newly diagnosed undifferentiated NPC patients younger than 19 years old treated at the National Institute of Oncology Sidi Mohamed Ben Abdellah in Rabat, Morocco, between 2010 and 2016. Patients had a median age of 16 years (range 8-19), with a sex ratio of 2.2. The mean time to presentation was 5.9 months. The main presenting symptom was cervical lymphadenopathy in 77% of cases. Stage I, II, III, and IVa patients accounted for 1.5%, 10.3%, 44.1%, and 39.7%, respectively. Three patients had bone metastases at the time of diagnosis. Forty-four patients received induction chemotherapy before concurrent chemoradiation, 23 patients received concurrent chemoradiotherapy alone with weekly cisplatin, and one patient underwent exclusive radiotherapy. After a mean follow-up of 38 months (range: 14.5 to 65), loco-regional control (LRC) and distant metastasis-free survival (DMFS) were 94.1% and 76.5%, respectively. The 5- and 10- year overall survival (OS) was 87% and 80.1%, respectively. The 5- and 10-year disease-free survival (DFS) was 75.3% and 66%, respectively. At the end of follow-up period, a total of 13 patients (19.1%) were lost to follow-up. Seven patients (10.3%) had died, and 48 patients (70.6%) were alive and without disease. Most common late complications were xerostomia, hearing loss, skin fibrosis, trismus and dental caries. In spite of the majority of children and adolescents with NPC diagnosed at the advanced stage, treatment combining chemotherapy and radiotherapy achieves an excellent local control rate. A higher interval time between symptom onset and consultation (> 6 months), and T stage (T3, T4) were the most relevant prognostic factors in this study.

Keywords: Adolescent, children, nasopharyngeal carcinoma, survival, treatment., Morocco