Successful combined therapy with neoadjuvant chemotherapy, concurrent chemoradiotherapy with IMRT, and interferon beta in a pediatric patient with nasopharyngeal carcinoma

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  • Dou Junko
    Department of Pediatrics, Kyoto Prefectural University of Medicine
  • Miyachi Mitsuru
    Department of Pediatrics, Kyoto Prefectural University of Medicine
  • Kuwahara Yasumichi
    Department of Pediatrics, Kyoto Prefectural University of Medicine
  • Nakano Hiroshi
    Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine
  • Nakamura Satoaki
    Department of Radiology, Kyoto Prefectural University of Medicine
  • Konishi Eiichi
    Department of Surgical Pathology, Kyoto Prefectural University of Medicine
  • Kuroda Hiroshi
    Department of Pediatrics, Kyoto City Hospital
  • Otsu Syuji
    Department of Radiology, Kyoto City Hospital
  • Iehara Tomoko
    Department of Pediatrics, Kyoto Prefectural University of Medicine
  • Hosoi Hajime
    Department of Pediatrics, Kyoto Prefectural University of Medicine

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Other Title
  • 化学療法とIMRT（強度変調放射線治療）とインターフェロンβによる集学的治療が奏功した小児上咽頭癌の1例

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We report the case of a 13-year-old girl with nasopharyngeal carcinoma (T3N3M0) who had complained of neck pain and hearing loss. A fiberscope revealed a mass of the nasopharynx, and endoscopic tumor biopsy was performed. The histopathological diagnosis was undifferentiated nasopharyngeal carcinoma associated with the Epstein-Barr virus. She received 3 courses of neoadjuvant chemotherapy (NAC) containing cisplatin, 5-fluorouracil and leucovorin, followed by IMRT and concurrent chemoradiotherapy (CCRT). Although the MR and PET-CT images showed a lesion remaining after the completion of NAC, the lesion was completely eliminated after CCRT. Furthermore, she was treated with IFN-β for 6 consecutive months. At present, 10 months after the treatment, she maintains complete remission. The adverse event can be relieved by administering IMRT. Furthermore, the levels of serum EBV-DNA reflected the effects of the treatment. To the best of our knowledge, this strategy for pediatric nasopharyngeal carcinoma was well tolerated and resulted in a very effective therapy.

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