ArticleFrontiers in immunology2026
New insights into the treatment of nasopharyngeal carcinoma in children, adolescents, and young adults: a retrospective study.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the efficacy, safety, and survival impacts of diverse induction chemotherapy regimens (including combination therapy with immune checkpoint inhibitors [ICIs]), radiotherapy modalities, and consolidation therapy in children, adolescents, and young adults (CAYA) with locally advanced or metastatic nasopharyngeal carcinoma (NPC). Methods: This multicenter retrospective study analyzed 102 CAYA NPC patients (aged 6-24 years; stage III-IVB) from two Chinese centers (January 2011-October 2024). All received induction therapy followed by concurrent chemoradiotherapy (CCRT), radiotherapy combined with concurrent anti-EGFR therapy, or radiotherapy alone, with select cases receiving consolidation (median follow-up: 22 months). Results: GP and TPF induction achieved higher objective response rates (ORR) vs. TP (GP: 68.0% vs. TP: 31.6%, P = 0.005; TPF: 89.5% vs. TP: 68.0%, P < 0.001), though no significant difference in long-term survival was observed. ICIs + chemotherapy (n=15) improved ORR (93.3% vs. 53.3%, P = 0.013) though without a demonstrable difference in survival metrics at this follow-up. In patients achieving partial response (PR) post-induction, CCRT/anti-EGFR therapy + radiotherapy improved 1-year progression-free survival (PFS: 94.5% vs. 50.0%, P < 0.001) and distant metastasis-free survival (DMFS: 97.4% vs. 50.0%, P < 0.001). For stable disease (SD) patients, multimodal therapy increased 5-year overall survival (OS: 100% vs. 66.7%, P = 0.046). Consolidation therapy (n=24) in locally advanced NPC was associated with clinical stage (P = 0.001) but not survival (P > 0.05). Conclusion: TPF/GP regimens improved short-term responses with manageable toxicity. The addition of ICIs enhanced objective response rates, though survival benefits were not assessable within the limited follow-up period. CCRT demonstrated survival advantages over radiotherapy alone, especially in PR patients, while consolidation therapy showed limited benefit except in advanced subgroups. These findings, generated from a retrospective analysis, highlight the need for personalized strategies and warrant validation in larger prospective trials.
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