Keeping Kids Kool—Influence of Induction, Advantage of Adaptation, Curtailment of Complications

This is a young, otherwise healthy patient with a bulky, Epstein-Barr virus (EBV)-associated nasopharyngeal carcinoma. Given the high initial disease burden, we would recommend 3 cycles of induction chemotherapy (gemcitabine 1000 mg/m2 days 1 and 8; cisplatin 80 mg/m2 day 1), followed by concurrent chemoradiation. In contrast to adults, for whom evidence supporting response-adapted dosing is lacking, a prospective pediatric trial (ARAR0331)...