Al Mousa A, et al. - Researchers sought to compare treatment outcomes of methotrexate, cisplatin, and 5-fluorouracil (MPF) or cisplatin and 5-fluorouracil (PF) in pediatric NPC patients treated with sequential chemoradiotherapy. They found that treatment outcome was not affected when methotrexate was omitted from the induction chemotherapy regimen.

Methods

• This study represents a retrospectively review of a total of 25 patients aged 18 years or below with stage II-IV NPC treated with IC using PF (n=16) or MPF (n=9) followed by radiotherapy between 2003 and 2009.
• Radiotherapy dose was 61.2 to 66.6 Gy to the gross disease.
• Univariate and multivariate analyses were used to test age, stage, radiation dose, and chemotherapy regimen as prognostic factors for event-free survival (EFS) and overall survival (OS).

Results

• Data showed that the median age at diagnosis was 13.3 years.
• Planned chemotherapy was completed by all patients.
• Researchers observed that all patients who received MPF achieved PR whereas 15 patients (93.8%) who received PF achieved PR (P=1).
• At 5 years, no differences were observed in EFS (68.75% vs. 66.67%; P=0.84) and OS (81.25% vs. 66.67%; P=0.39) between PF and MPF, respectively.
• Findings demonstrated that only tumor stage (IV vs. II-III) predicted worse OS on multivariate analysis (hazard ratio, 10.3; 95% confidence interval, 1.197-88.974) but not EFS (hazard ratio, 4.805; 95% confidence interval, 0.95-24.336).
• Additionally, it was noted that distant metastases was the predominant site of failure, seen in 5 patients (20%).