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

Abstract

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.