Nasopharyngeal carcinoma in the young

This study reviewed 25 patients with nasopharyngeal carcinoma who were less than 30 years of age at diagnosis. Lymphoepithelioma was the histological diagnosis in all three. The anatomical extent of disease was described using the TNM system. Local bone destruction was present in 10 patients at diagnosis; cervical nodes were clinically positive in 88% of patients of which 54% were bilateral. All were treated with radical irradiation using a variety of techniques and doses. No patient received adjuvant chemotherapy. Overall survival was 70% at 5 years and 57% at 10 years from diagnosis. There were 5 relapses at the primary site, 2 in cervical nodes and 8 in bone or lung. Primary site relapse was not demonstrated to be dependant on T group or radiation dose, but likely related to inadequacy of original treatment volume. Distant metastases at first relapse correlated with advanced T and N and were the principal obstacle to successful treatment. Adjuvant chemotherapy is suggested as an important target for further study