Clinico-pathologic profile and treatment outcome of children with nasopharyngeal cancer seen at pediatric hemato-oncology unit of TASH, Ethiopia
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Date
2024-04
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Addis Ababa University
Abstract
Background: As an unusual disease in children, nasopharyngeal cancer has variable incidence
among nations around the world. There are insufficient studies from non-endemic areas like
ours and similar LMICs. It is usually diagnosed late in the more advanced stages of the disease.
Histologic presentation and treatment outcome is especially different among children and yet
therapeutic approaches have been extrapolated from guidelines made for adults.
Objective: To assess the sociodemographic, clinico-pathologic profile and treatment outcome
of children with nasopharyngeal cancer seen at pediatric hemato-oncology unit of TASH
Methods: This is a cross-sectional descriptive review of pediatric patients who were treated for
nasopharyngeal carcinoma at Tikur Anbessa Specialized Hospital. The hospital’s database and
patients’ chart review was done to collect data on the diagnosis and management of NPC
during the study period. All eligible pediatric patients who were on follow-up beginning from
January 2018 to January 2024 were assessed for their clinico-pathologic profile and treatment
outcome. A questionnaire was used to collect the clinical data including sociodemographics,
clinical, radiologic and pathologic reports along with the treatment oucome. The data was
entered into SPSS for analysis. The relationship between the independent and dependent
variables was explained through chi-sqaure analysis. The overall and event-free survival of the
patients was estimated using Kaplan-meier analysis.
Result: Out of the 31 patients in the study, 61.3% were male with a M:F ratio of 1.6:1. Their
ages ranged from 6-18 years with the median age of presentation being 14 years. The majority
of cases came from Oromia region accounting for 38.7% of case. The major presenting
symptom was neck mass (90.3%) followed by nasal congestion and epistaxis. The duration of
illness upon presentation ranged from 8 weeks to 2 years with a median of 21 weeks. 64.5% of
the patients presented with T4 stage disease. Undifferentiated histology predominated
accounting for 77% cases. All patients were started with chemotherapy but only 58.1% could
gain access to radiotherapy. There was significantly low overall and event-free survival at 3
years with 42% and 20% respectively.
Conclusion: Nasopharyngeal cancer commonly presents in pre-adolescent and adolescent
age groups with a unilateral or bilateral neck swelling. Most presentations are loco-regionally
advanced and undifferentiated in histology. Treatment is via concurrent chemoradiotherapy with
survival significantly lower than the developed world’s counterparts.
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Keywords
Nasopharyngeal carcinoma, Pediatrics, Children, Ethiopia