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
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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