Combining pretreatment plasma Epstein‐Barr virus DNA level and cervical node necrosis improves prognostic stratification in patients with nasopharyngeal carcinoma: A cohort study
Autor: | Dong Hua Luo, Hai Qiang Mai, Xue Song Sun, Wan Ru Zhang, Jing Hua Zhong, Lin Quan Tang, Hao Yuan Mo, Dong Mei Mai, Wen Hui Chen, Qiu Yan Chen, Yu Yun Du |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Oncology Male Cancer Research Herpesvirus 4 Human Multivariate analysis medicine.medical_treatment Kaplan-Meier Estimate Cohort Studies 0302 clinical medicine Clinical endpoint Original Research Chemoradiotherapy cohort Middle Aged Prognosis lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Neoadjuvant Therapy cervical node necrosis Chemotherapy Adjuvant 030220 oncology & carcinogenesis Lymphatic Metastasis Cohort Female Sentinel Lymph Node Cohort study Adult medicine.medical_specialty Adolescent Antineoplastic Agents lcsh:RC254-282 Virus 03 medical and health sciences Necrosis Young Adult EBV Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Aged Chemotherapy business.industry nasopharyngeal carcinoma Clinical Cancer Research Nasopharyngeal Neoplasms medicine.disease Radiation therapy 030104 developmental biology Nasopharyngeal carcinoma DNA Viral Cisplatin business |
Zdroj: | Cancer Medicine, Vol 8, Iss 16, Pp 6841-6852 (2019) Cancer Medicine |
ISSN: | 2045-7634 |
Popis: | This study aimed to evaluate the prognostic value of combining pretreatment Epstein‐Barr virus (EBV) DNA level and cervical node necrosis (CNN) for patients with nasopharyngeal carcinoma (NPC) receiving intensity‐modulated radiotherapy (IMRT). A total of 607 incident nonmetastatic NPC patients treated with IMRT ± chemotherapy were reviewed. Patients were divided into four groups based on EBV DNA level and CNN status. The primary endpoint was progression‐free survival (PFS). Kaplan‐Meier curves with log‐rank test were applied to compare survival outcomes and the Cox proportional model was used to identify independent prognostic factors. Pretreatment EBV DNA level and CNN status were independent prognostic factors. Patients in the low‐level EBV DNA group or non‐CNN group had significantly better 5‐year PFS. Multivariate analyses demonstrated that CNN was an independent prognostic factor for overall survival (OS) (HR = 1.927, 95% CI: 1.129‐3.290, P = .016), PFS (HR = 1.492, 95% CI: 1.005‐2.214, P = .047), distant metastasis‐free survival (DMFS) (HR = 1.661, 95% CI: 1.044‐2.644, P = .032), but not locoregional relapse‐free survival. EBV DNA levels correlated significantly with CNN with a correlation coefficient of .324 (P It is the first retrospective study that combined pretreatment plasma EBV DNA level and cervical node necrosis (CNN) status to assess the prognosis of nasopharyngeal carcinoma patients. We observed a significant association between plasma EBV DNA level and CNN status in the IMRT era. Compared with the low‐level EBV DNA and non‐CNN group, the high‐level EBV DNA and CNN group had poorer OS, progression‐free survival, and distant metastasis‐free survival. The Kaplan–Meier survival curves showed a significant difference in survival between the different risk groups according to the optimal cut‐off. |
Databáze: | OpenAIRE |
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