International Journal of Pediatric Otorhinolaryngology 79 (2015) 1279–1282
Contents lists available at ScienceDirect
International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl
Pediatric head and neck squamous cell carcinoma: Report of 12 cases and illustrated review of literature V. Bhanuprasad, Supriya Mallick *, Suman Bhasker, Bidhu Kalyan Mohanti Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
A R T I C L E I N F O
A B S T R A C T
Article history: Received 26 March 2015 Received in revised form 20 May 2015 Accepted 20 May 2015 Available online 30 May 2015
Introduction: Head and neck carcinoma is a very rare entity in pediatric age group. We here present the demography, treatment and outcome of 12 pediatric patients. Methodology: We retrieved the treatment charts of pediatric patients with a diagnosis of head and neck squamous cell carcinoma (PHNSCC). We also retrieved the published literature of pediatric HNSCC to present the treatment modalities being delivered across institutes. Results: We found 12 patients registered with a diagnosis of squamous cell carcinoma. Median age of the entire cohort was 17 years (Range: 8–20). Gender predilection was skewed in favor of male (male:female ratio—11:1). Oral tongue 3(25%) was the commonest sub site followed by soft palate 2(17%) gingiva 2 (17%), supra glottis larynx 2(17%) and one each of hard palate, buccal mucosa, floor of mouth (8.25% each). The most commonly employed modality of treatment was surgery in 6(50%). Radiation was used in seven cases: 7(Adjuvant-4, Radical-3). Two patients received radical chemo-radiation. Neo-adjuvant chemotherapy was used in two cases. Median follow up duration was 2 years (Range: 6 months to 8 years). One patient recurred 6 months post completion of radical chemo-radiation. The patient with recurrent disease had soft palate primary and had isolated local recurrence. The patient was salvaged with surgery and was disease free at the last follow up. At the last follow up all patients were surviving without disease. Conclusion: The treatment and survival are not much different in pediatric patients compared to adult counterpart. However, in the absence of molecular profiling it is difficult to assess the cause of development of SCC in pediatric patients. A detailed study of underlying molecular pathway will further guide the future treatment. ß 2015 Elsevier Ireland Ltd. All rights reserved.
Keywords: Pediatric Squamous cell carcinoma Radiotherapy
1. Introduction Pediatric head and neck squamous cell carcinoma (PHNSCC) (defined as 20 Years) is a rare entity accounting for 4 cm, involved margins, close margins as defined as 4 mm. Patients with oropharyngeal and laryngeal primary were treated with radical chemoradiation with or without neoadjuvant chemotherapy.
3.1. Demographic profile
2.2. Surgery Surgery was contemplated in all cases with oral cavity primary. A wide local excision with Neck dissection was performed. Patients with a N0 neck underwent a supra-omohyoid neck dissection whereas a modified radical neck dissection was performed for node positive neck. Adjuvant radiation was delivered for T3/T4 primary, more than 4 mm depth of invasion for T1/T2 oral tongue primary, Node positive neck, close margin (
Contents lists available at ScienceDirect
International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl
Pediatric head and neck squamous cell carcinoma: Report of 12 cases and illustrated review of literature V. Bhanuprasad, Supriya Mallick *, Suman Bhasker, Bidhu Kalyan Mohanti Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
A R T I C L E I N F O
A B S T R A C T
Article history: Received 26 March 2015 Received in revised form 20 May 2015 Accepted 20 May 2015 Available online 30 May 2015
Introduction: Head and neck carcinoma is a very rare entity in pediatric age group. We here present the demography, treatment and outcome of 12 pediatric patients. Methodology: We retrieved the treatment charts of pediatric patients with a diagnosis of head and neck squamous cell carcinoma (PHNSCC). We also retrieved the published literature of pediatric HNSCC to present the treatment modalities being delivered across institutes. Results: We found 12 patients registered with a diagnosis of squamous cell carcinoma. Median age of the entire cohort was 17 years (Range: 8–20). Gender predilection was skewed in favor of male (male:female ratio—11:1). Oral tongue 3(25%) was the commonest sub site followed by soft palate 2(17%) gingiva 2 (17%), supra glottis larynx 2(17%) and one each of hard palate, buccal mucosa, floor of mouth (8.25% each). The most commonly employed modality of treatment was surgery in 6(50%). Radiation was used in seven cases: 7(Adjuvant-4, Radical-3). Two patients received radical chemo-radiation. Neo-adjuvant chemotherapy was used in two cases. Median follow up duration was 2 years (Range: 6 months to 8 years). One patient recurred 6 months post completion of radical chemo-radiation. The patient with recurrent disease had soft palate primary and had isolated local recurrence. The patient was salvaged with surgery and was disease free at the last follow up. At the last follow up all patients were surviving without disease. Conclusion: The treatment and survival are not much different in pediatric patients compared to adult counterpart. However, in the absence of molecular profiling it is difficult to assess the cause of development of SCC in pediatric patients. A detailed study of underlying molecular pathway will further guide the future treatment. ß 2015 Elsevier Ireland Ltd. All rights reserved.
Keywords: Pediatric Squamous cell carcinoma Radiotherapy
1. Introduction Pediatric head and neck squamous cell carcinoma (PHNSCC) (defined as 20 Years) is a rare entity accounting for 4 cm, involved margins, close margins as defined as 4 mm. Patients with oropharyngeal and laryngeal primary were treated with radical chemoradiation with or without neoadjuvant chemotherapy.
3.1. Demographic profile
2.2. Surgery Surgery was contemplated in all cases with oral cavity primary. A wide local excision with Neck dissection was performed. Patients with a N0 neck underwent a supra-omohyoid neck dissection whereas a modified radical neck dissection was performed for node positive neck. Adjuvant radiation was delivered for T3/T4 primary, more than 4 mm depth of invasion for T1/T2 oral tongue primary, Node positive neck, close margin (
