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Plasma Epstein-Barr Virus DNA and Residual Disease After Radiotherapy for Undifferentiated Nasopharyngeal Carcinoma

JNCI : Journal of the National Cancer Institute, 2002-11, Vol.94 (21), p.1614-1619 [Peer Reviewed Journal]

2003 INIST-CNRS ;Copyright Oxford University Press(England) Nov 6, 2002 ;ISSN: 0027-8874 ;ISSN: 1460-2105 ;EISSN: 1460-2105 ;DOI: 10.1093/jnci/94.21.1614 ;PMID: 12419787 ;CODEN: JNCIEQ

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Title:
Plasma Epstein-Barr Virus DNA and Residual Disease After Radiotherapy for Undifferentiated Nasopharyngeal Carcinoma
Author: Chan, Anthony T. C. ; Lo, Y. M. Dennis ; Zee, Benny ; Chan, Lisa Y. S. ; Ma, Brigette B. Y. ; Leung, Sing-Fai ; Mo, Frankie ; Lai, Maria ; Ho, Stephen ; Huang, Dolly P. ; Johnson, Philip J.
Subjects: Adult ; Aged ; Biological and medical sciences ; Cancer ; Carcinoma - radiotherapy ; Deoxyribonucleic acid ; Disease-Free Survival ; Diseases of the upper aerodigestive tract ; DNA ; DNA, Viral - blood ; DNA, Viral - isolation & purification ; Ent and stomatology ; Female ; Follow-Up Studies ; Herpesvirus 4, Human - isolation & purification ; Humans ; Lymphatic Metastasis ; Male ; Medical sciences ; Middle Aged ; Nasopharyngeal Neoplasms - mortality ; Nasopharyngeal Neoplasms - pathology ; Nasopharyngeal Neoplasms - radiotherapy ; Neoplasm Staging ; Neoplasm, Residual - mortality ; Neoplasm, Residual - pathology ; Neoplasm, Residual - virology ; Plasma ; Polymerase Chain Reaction - methods ; Radiology ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Retrospective Studies ; Survival Rate ; Time Factors ; Tropical medicine ; Viruses
Is Part Of: JNCI : Journal of the National Cancer Institute, 2002-11, Vol.94 (21), p.1614-1619
Description: Background: Epstein-Barr virus (EBV) DNA can be detected and quantified in the plasma of patients with EBV-related tumors, such as nasopharyngeal carcinoma (NPC). Although NPC at early stages can be cured by radical radiotherapy, there is a high recurrence rate in patients with advanced NPC. The pretreatment level of circulating EBV DNA is a prognostic factor for NPC, but the prognostic value of post-treatment EBV DNA has not been studied. We designed a prospective study in Hong Kong, China, to investigate the value of plasma EBV DNA as a prognostic factor for NPC. Methods: One hundred seventy NPC patients, without metastatic disease at presentation, were treated with a uniform radiotherapy protocol. Circulating EBV DNA was measured by real-time quantitative polymerase chain reaction before treatment and 6–8 weeks after radiotherapy was completed. Risk ratios (RRs) were determined with a Cox regression model, and associations of various factors with progression-free and overall survival and recurrence rates were determined with a stepwise Cox proportional hazards model. All statistical tests were two-sided. Results: Ninety-nine percent of patients achieved complete clinical remission. Levels of post-treatment EBV DNA dominated the effect of levels of pretreatment EBV DNA for progression-free survival. The RR for NPC recurrence was 11.9 (95% confidence interval [CI] = 5.53 to 25.43) for patients with higher post-treatment EBV DNA and 2.5 (95% CI = 1.14 to 5.70) for patients with higher pretreatment EBV DNA. Higher levels of post-treatment EBV DNA were statistically significantly associated with overall survival (P<.001; RR for NPC recurrence = 8.6, 95% CI = 3.69 to 19.97). The positive and negative predictive values for NPC recurrence for a higher level of post-treatment EBV DNA were 87% (95% CI = 58% to 98%) and 83% (95% CI = 76% to 89%), respectively. Conclusion: Levels of post-treatment plasma EBV DNA in patients with NPC appear to strongly predict progression-free and overall survival and to accurately reflect the post-treatment residual tumor load.
Publisher: Cary, NC: Oxford University Press
Language: English
Identifier: ISSN: 0027-8874
ISSN: 1460-2105
EISSN: 1460-2105
DOI: 10.1093/jnci/94.21.1614
PMID: 12419787
CODEN: JNCIEQ
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
Alma/SFX Local Collection

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Plasma Epstein-Barr Virus DNA and Residual Disease After Radiotherapy for Undifferentiated Nasopharyngeal Carcinoma

2003 INIST-CNRS ;Copyright Oxford University Press(England) Nov 6, 2002 ;ISSN: 0027-8874 ;ISSN: 1460-2105 ;EISSN: 1460-2105 ;DOI: 10.1093/jnci/94.21.1614 ;PMID: 12419787 ;CODEN: JNCIEQ

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