{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:26:45Z","timestamp":1793608005665,"version":"4.5.0"},"reference-count":35,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100019018","name":"Chinese Academy of Medical Sciences Initiative for Innovative Medicine","doi-asserted-by":"publisher","award":["T-B-056"],"award-info":[{"award-number":["T-B-056"]}],"id":[{"id":"10.13039\/501100019018","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC2411602"],"award-info":[{"award-number":["2023YFC2411602"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","redjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Radiation Oncology*Biology*Physics"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.ijrobp.2026.04.003","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T06:12:35Z","timestamp":1776233555000},"page":"347-358","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Childhood Nasopharyngeal Carcinoma: A Rare Disease With Distinct Features and Favorable Prognosis"],"prefix":"10.1016","volume":"126","author":[{"given":"Shiran","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijun","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingbo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianghu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwei","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye-Xiong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runye","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7083-0216","authenticated-orcid":false,"given":"Junlin","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijrobp.2026.04.003_bib0001","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1002\/1097-0142(19900901)66:5<968::AID-CNCR2820660527>3.0.CO;2-A","article-title":"Cancer of the nasopharynx in childhood","volume":"66","author":"Huang","year":"1990","journal-title":"Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0002","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1186\/s13014-014-0274-7","article-title":"Nasopharyngeal carcinoma in children and adolescents - A single institution experience of 158 patients","volume":"9","author":"Liu","year":"2014","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0003","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1002\/cncr.21258","article-title":"Treatment of nasopharyngeal carcinoma in children and adolescents: Definitive results of a multicenter study (NPC-91-GPOH)","volume":"104","author":"Mertens","year":"2005","journal-title":"Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0004","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s40880-017-0257-9","article-title":"Nasopharyngeal carcinoma incidence and mortality in China, 2013","volume":"36","author":"Wei","year":"2017","journal-title":"Chin J Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0005","doi-asserted-by":"crossref","first-page":"3369","DOI":"10.1200\/JCO.19.01276","article-title":"Treatment of childhood nasopharyngeal carcinoma with induction chemotherapy and concurrent chemoradiotherapy: Results of the Children\u2019s Oncology Group ARAR0331 study","volume":"37","author":"Rodriguez-Galindo","year":"2019","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0006","doi-asserted-by":"crossref","first-page":"3124","DOI":"10.1158\/1078-0432.CCR-24-3546","article-title":"One-two punch: Combining chemotherapy and immunotherapy to decrease radiation dose and related toxicity in children and adolescents with nasopharyngeal carcinoma","volume":"31","author":"Dholaria","year":"2025","journal-title":"Clin Cancer Res"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0007","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ejca.2021.09.045","article-title":"Induction or adjuvant chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in paediatric nasopharyngeal carcinoma in the IMRT era: A recursive partitioning risk stratification analysis based on EBV DNA","volume":"159","author":"Liang","year":"2021","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0008","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1007\/s00432-017-2401-y","article-title":"A retrospective study comparing the outcomes and toxicities of intensity-modulated radiotherapy versus two-dimensional conventional radiotherapy for the treatment of children and adolescent nasopharyngeal carcinoma","volume":"143","author":"Qiu","year":"2017","journal-title":"J Cancer Res Clin Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0009","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1002\/ijc.33293","article-title":"Clinicopathological and prognostic features of nasopharyngeal carcinoma in children and adolescents: A retrospective study of 196 cases in South China","volume":"148","author":"Zhang","year":"2021","journal-title":"Int J Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0010","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.0173","article-title":"Association of treatment advances with survival rates in pediatric patients with nasopharyngeal carcinoma in China, 1989-2020","volume":"5","author":"Liang","year":"2022","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0011","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.ijrobp.2019.11.035","article-title":"Comparison of long-term outcomes and sequelae between children and adult nasopharyngeal carcinoma treated with intensity modulated radiation therapy","volume":"106","author":"Chen","year":"2020","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0012","doi-asserted-by":"crossref","first-page":"8613","DOI":"10.2147\/CMAR.S260402","article-title":"Comparison of prognosis between juvenile and adult nasopharyngeal carcinoma: A propensity score-matched analysis","volume":"12","author":"Chen","year":"2020","journal-title":"Cancer Manag Res"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0013","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2020.104779","article-title":"Is nasopharyngeal carcinoma in young patients a distinct clinical entity? A single-institution case matched analysis in the era of intensity-modulated radiotherapy","volume":"107","author":"Ou","year":"2020","journal-title":"Oral Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0014","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.radonc.2021.06.003","article-title":"Optimal cumulative cisplatin dose during concurrent chemoradiotherapy among children and adolescents with locoregionally advanced nasopharyngeal carcinoma: A real-world data study","volume":"161","author":"Jin","year":"2021","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0015","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2022.11.003","article-title":"The feasibility of reduced-dose radiotherapy in childhood nasopharyngeal carcinoma with favorable response to neoadjuvant chemotherapy","volume":"178","author":"Yao","year":"2023","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0016","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.ejca.2021.05.022","article-title":"A systematic review and recommendations on the use of plasma EBV DNA for nasopharyngeal carcinoma","volume":"153","author":"Lee","year":"2021","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0017","doi-asserted-by":"crossref","DOI":"10.1016\/j.canlet.2024.217276","article-title":"Significance of longitudinal Epstein-Barr virus DNA combined with multipoint tumor response for dynamic risk stratification and treatment adaptation in nasopharyngeal carcinoma","volume":"605","author":"Liu","year":"2024","journal-title":"Cancer Lett"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0018","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1038\/s41746-025-01918-2","article-title":"Treatment response-adapted risk index model for survival prediction and adjuvant chemotherapy selection in nonmetastatic nasopharyngeal carcinoma","volume":"8","author":"Liu","year":"2025","journal-title":"NPJ Digit Med"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0019","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.ijrobp.2015.08.003","article-title":"The prognostic value of plasma Epstein-Barr viral DNA and tumor response to neoadjuvant chemotherapy in advanced-stage nasopharyngeal carcinoma","volume":"93","author":"Liu","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0020","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1002\/cncr.30520","article-title":"Tumor response to neoadjuvant chemotherapy predicts long-term survival outcomes in patients with locoregionally advanced nasopharyngeal carcinoma: A secondary analysis of a randomized phase 3 clinical trial","volume":"123","author":"Peng","year":"2017","journal-title":"Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0021","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.radonc.2019.04.020","article-title":"Optimal cumulative cisplatin dose in nasopharyngeal carcinoma patients based on induction chemotherapy response","volume":"137","author":"Liu","year":"2019","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0022","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1159\/000537988","article-title":"Clinicopathologic features and efficacy of induction chemotherapy in nasopharyngeal carcinoma: Real-world experience","volume":"47","author":"Majidova","year":"2024","journal-title":"Oncol Res Treat"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0023","doi-asserted-by":"crossref","first-page":"2718","DOI":"10.1002\/cncr.26528","article-title":"A prospective protocol for nasopharyngeal carcinoma in children and adolescents: The Italian Rare Tumors in Pediatric Age (TREP) project","volume":"118","author":"Casanova","year":"2012","journal-title":"Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0024","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1007\/s00066-019-01461-6","article-title":"Adapted strategy to tumor response in childhood nasopharyngeal carcinoma: The French experience","volume":"195","author":"Jouin","year":"2019","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0025","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.3390\/cancers14051261","article-title":"Multimodal treatment of nasopharyngeal carcinoma in children, adolescents and young adults-Extended follow-up of the NPC-2003-GPOH study cohort and patients of the interim cohort","volume":"14","author":"R\u00f6mer","year":"2022","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0026","volume":"40","author":"Luo","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0027","unstructured":"A study using nivolumab, in combination with chemotherapy drugs to treat nasopharyngeal carcinoma (NPC). ClinicalTrials.gov identifier: NCT06064097. Updated April 13, 2026. Accessed May 3, 2026. https:\/\/clinicaltrials.gov\/study\/NCT06064097"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0028","unstructured":"Nivolumab in children and adults with nasopharyngeal carcinoma (NPC-Nivo). ClinicalTrials.gov identifier: NCT06019130. Updated May 16, 2024. Accessed May 3, 2026. https:\/\/clinicaltrials.gov\/study\/NCT06019130"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0029","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/S1470-2045(16)30410-7","article-title":"Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: A phase 3, multicentre, randomised controlled trial","volume":"17","author":"Sun","year":"2016","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0030","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1056\/NEJMoa1905287","article-title":"Gemcitabine and cisplatin induction chemotherapy in nasopharyngeal carcinoma","volume":"381","author":"Zhang","year":"2019","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0031","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1002\/hed.24345","article-title":"Oligometastases in AJCC stage IVc nasopharyngeal carcinoma: A subset with better overall survival","volume":"38","author":"Tian","year":"2016","journal-title":"Head Neck"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0032","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ejca.2017.02.029","article-title":"Establishment and validation of M1 stage subdivisions for de novo metastatic nasopharyngeal carcinoma to better predict prognosis and guide treatment","volume":"77","author":"Zou","year":"2017","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0033","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3389\/fonc.2019.00240","article-title":"A nomogram for the prediction of prognosis in patients with distant metastases of nasopharyngeal carcinoma","volume":"9","author":"Zhao","year":"2019","journal-title":"Front Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0034","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2022.106218","article-title":"Molecular characteristics of pediatric nasopharyngeal carcinoma using whole-exome sequencing","volume":"135","author":"Wu","year":"2022","journal-title":"Oral Oncol"},{"key":"10.1016\/j.ijrobp.2026.04.003_bib0035","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ijrobp.2018.09.015","article-title":"Late sequelae of childhood and adolescent nasopharyngeal carcinoma survivors after radiation therapy","volume":"103","author":"Lu","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["International Journal of Radiation Oncology*Biology*Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301626005675?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301626005675?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:35:17Z","timestamp":1793604917000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0360301626005675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S0360301626005675"],"URL":"https:\/\/doi.org\/10.1016\/j.ijrobp.2026.04.003","relation":{},"ISSN":["0360-3016"],"issn-type":[{"value":"0360-3016","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Childhood Nasopharyngeal Carcinoma: A Rare Disease With Distinct Features and Favorable Prognosis","name":"articletitle","label":"Article Title"},{"value":"International Journal of Radiation Oncology*Biology*Physics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijrobp.2026.04.003","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}