Evaluation of radiotherapy dose and survival outcomes for teenagers, and young adults with nasopharyngeal carcinoma in UK & Ireland.

BACKGROUND AND PURPOSE: Nasopharyngeal carcinoma (NPC) follows a bimodal distribution with a smaller incidence peak in teenagers and young adults (TYAs). In TYAs, an over-whelming proportion are associated with Epstein-Barr virus (EBV). Given the rarity of TYA NPC and the lack of consensus regarding optimal management, we have evaluated the variation in treatment patterns across the UK and Ireland, with particular focus on variation between paediatric (PP) and adult (AP) treatment protocols and associated survival outcomes.

MATERIALS AND

METHODS

We performed a multicentre, observational cohort study, of patients aged 13-25 years, with histologically confirmed NPC, treated between the years 2002-2022. An initial expression of interest was sent to selected centres treating H&N patients in the UK and Ireland.

RESULTS

One-hundred and one eligible patients were identified across 10 treatment centres. 55% of patients were treated on an AP and 45% were treated on a PP. The median follow-up was 46-months (Interquartile range (IQR) 25-101). At the time of analysis, 86% of patients were alive without evidence of disease. There was no significant difference in PFS survival between cohorts at 3 and 5 years (83.5 % vs 82.8 vs and 83.5% vs 82.8 respectively) or OS at 3 and 5 years (97.8% vs 88.1% and 88.5% vs 84.7%). Eleven patients developed distant metastasis (DM) (4 PP (8.7%) vs 7 AP (12.7%)).

CONCLUSION

Our study suggests that PP regimes may adequately treat EBV-positive TYA NPC. Given the rarity of this disease, prospective evaluation, as part of an International collaboration, is required.