Prognostic role of plasma Epstein-Barr virus DNA load for nasopharyngeal carcinoma: a meta-analysis

Liu, Tingbo; Zheng, Zhaohui; Pan, Jie; Pan, Lili; Chen, Lihong

doi:10.25011/cim.v40i1.28049

Cited by 48 publications

(36 citation statements)

References 39 publications

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“…The disease clusters within families. The most consistent evidence implicates an association between HLA and NPSCC which is biologically plausible given the central role of (i) EBV in NPSCC and (ii) of HLA in immune presentation/handling of antigens [16-18]. …”

Section: Tobacco/alcohol and The Subsets Of Hnsccmentioning

confidence: 99%

HPV in Head and Neck Carcinomas: Different HPV Profiles in Oropharyngeal Carcinomas – Why?

Syrjänen

2019

Acta Cytologica

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Background: The association of human papillomavirus (HPV) with head and neck squamous cell carcinoma (HNSCC) was first described in 1982–1983 by the authors of this review. Prompted by this discovery 35 years ago, an entirely new field of HPV research has emerged, resulting in a paradigm shift from smoking and alcohol as the only etiological factors to confirmation of HNSCC as an important group of HPV-related human malignancies. Summary: In this review, the authors first describe the scope (i.e., HNSCC) by the anatomic sites of the tumors. Their important site-specific differences in epidemiology are emphasized, and the misconceptions caused by the adopted practice of pooling all tumors from these divergent anatomic sites as a single entity (HNSCC) are pinpointed. The convincing evidence of the established risk factors (smoking and alcohol) is briefly addressed, before entering in the discussion on the causal role of HPV in HNSCC pathogenesis. The global HPV prevalence in different subsets of HNSCC is summarized using the data extracted from all meta-analyses published since 2010. Of all HNSCC subsets, oropharyngeal SCC has an HPV profile distinct form all the other subsets, and the possible mechanisms explaining this intimate association with HPV are discussed. Key Messages: Recent global trends show a constant increase in HNSCC rates particularly among younger age groups. The evidence on cigarette smoking and alcohol consumption as the prime risk factors of HNSCC is overwhelming. During the past 35 years, however, increasing evidence has accumulated implicating an important causal role of HPV in HNSCC. These data have important clinical implications, HPV detection and tailored treatment strategies for HPV-positive HNSCCs currently being an integral part of the oncological management practices of HNSCC.

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Section: Tobacco/alcohol and The Subsets Of Hnsccmentioning

confidence: 99%

HPV in Head and Neck Carcinomas: Different HPV Profiles in Oropharyngeal Carcinomas – Why?

Syrjänen

2019

Acta Cytologica

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“…Besides gross tumor regression, plasma EBV DNA levels are monitoring indexes during NPC treatment in the clinic. There have been a number of studies confirming that plasma EBV DNA levels are important prognostic factors before treatment, and it is also an indicator warning tumor relapse in follow-up of NPC patients [16][17][18]. However, it is a lack of studies on the influences of plasma EBV DNA levels at the end of IMRT on survival of NPC patients.…”

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confidence: 99%

Prognostic value of gross tumor regression and plasma Epstein Barr Virus DNA levels at the end of intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma

Liang

Zhang

Chen

et al. 2019

Radiotherapy and Oncology

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a b s t r a c tPurpose: To assess gross tumor regression and plasma Epstein-Barr virus (EBV)-DNA levels at the end of intensity-modulated radiation therapy (IMRT) and its prognostic impact on patients with nasopharyngeal carcinoma (NPC). Participants and Methods: In total, 397 patients with non-metastatic, histologically confirmed NPC were retrospectively examined. All patients underwent magnetic resonance imaging of the nasopharynx and neck, and plasma EBV DNA assays before treatment and at the end of IMRT. Results: The estimated 5-year loco-regional, local and regional relapse-free survival rates for patients with complete response (CR) and non-CR of the total tumor, primary tumor and metastatic lymph nodes at the end of IMRT were 94.9% vs. 85.8%, 96.6% vs. 87.3%, and 98.7% vs. 89.8%, respectively (P < 0.05). The estimated 5-year loco-regional relapse-free survival (LRRFS) rates for patients with persistent tumor with and without boost irradiation were 95.3% vs. 83%, respectively (P = 0.034). The estimated 5-year overall survival (OS), failure-free survival (FFS) and distant metastasis-free survival (DMFS) rates for patients with negative and positive plasma EBV DNA at the end of IMRT were 83.1% vs. 50.3%, 81.5% vs. 49.3%, and 87.6% vs. 61.5%, respectively (P < 0.001). Multivariate analyses indicated that regression of the total tumor and boost irradiation was an independent predictor of LRRFS, and plasma EBV DNA levels were independent predictors of OS, FFS and DMFS. Conclusions: Gross tumor regression and plasma EBV DNA levels at the end of IMRT served as predictors of poor prognosis for patients with NPC. The patients with persistent tumor and/or positive plasma EBV DNA might require timely strengthening treatment. Ó 2018 The Authors. Published by Elsevier B.V. Radiotherapy and Oncology 132 (2019) 223-229 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Radical radiotherapy (RT) is the first treatment option for nonmetastatic nasopharyngeal carcinoma (NPC). Intensity-modulated radiation therapy (IMRT) was a milestone development in RT technology, as IMRT can provide a high conformal radiation dose to the tumor target area while effectively decreasing the dose to the sur-rounding normal tissues. IMRT, instead of 2-dimensional RT (2-DRT) and 3-dimensional conformal RT (3-DCRT), is currently more commonly used to treat NPC, due to the associated better tumor control and lower RT-related toxicities [1][2][3][4][5]. The 5-year overall survival (OS), 5-year local relapse-free survival (LRFS), 5-year regional relapse-free survival (RRFS), and 5-year distant metastasis-free survival (DMFS) rates of patients with NPC treated with IMRT ranged from 74% to 84%, 83% to 95%, 91% to 97%, and 83.3% to 85.6%, respectively [6][7][8][9][10].Both loco-regional relapse and distant metastasis are the main reasons of treatment failure in patients with NPC [6-10]. Due to the poor survival of patients with loco-regional relapse and distant metastasis, some effective the...

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“…Second, another potentially valuable prognostic factor (EBV DNA) was not be considered. Increasing research studies have confirmed that plasma EBV DNA is an important marker for survival [24][25][26] . However, this is not a routine examination item in most centers, and not all patients have these relevant data.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma

Jiang

Pan

et al. 2020

Sci Rep

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the tnM staging system of npc is the most important model for survival prediction. However, this model does not consider the biological variability of the tumor itself. this study aimed to develop a nomogram for predicting the overall survival of loco-regionally advanced nasopharyngeal carcinoma. 487 Patients with confimed nasopharyngeal carcinoma who underwent IMRT and chemotherapy were included in this study. We established prognostic nomogram for overall survival (oS) based on the cox proportional hazards model. the predictive accuracy and discriminative ability were measured using the concordance index (c-index) and calibration curve. nomogram was validated externally by assessing discrimination and calibration using an independent data set. Continuous net reclassification improvement (nRi) and integrated discrimination improvement (iDi) were used to analyze whether nomogram improve the prediction of survival than tnM stage system. Recursive partitioning analysis (RpA) was performed to stratifying risk of patients. Age, t-stage, n-stage, nLR, LDH were included in the nomogram for OS. The C-index of the nomogram for OS were 0.726 (95% CI, 0.690 to 0.762); The calibration curve showed the nomogram was able to predict 5-year OS accurately. The nomogram had a higher C-index than the TNM stage system (0.726 VS 0.632, P-value < 0.001). The NRI was 0.235 (95% CI: 0.129 to 0.396, P < 0.001), the IDI was 0.079 (95% CI: 0.034 to 0.396, p < 0.001). RPA was performed to stratify patients into three risk group, OS was significantly different between all three risk groups. High risk groups can be benefited survival from adjuvant chemotherapy. The nomogram outperformed the tnM staging system in predicting the oS of loco-regionally advanced nasopharyngeal carcinoma underwent intensity modulated radiation therapy and chemotherapy. Nasopharyngeal carcinoma (NPC) is endemic to the south of China and Asia; an NPC incidence of 2 per million people in China has been reported 1. More than 70% of the newly diagnosed cases are classified as locoregionally advanced disease 2. Concurrent chemoradiotherapy is the standard treatment for locally advanced nasopharyngeal carcinoma 3. However, in some patients, the disease progresses within a few years after chemoradiotherapy. Therefore, identifying a prognostic model for early progression would allow for a better therapeutic plan. The TNM staging system of NPC is the most important model for survival prediction. However, this model does not consider the biological variability of the tumor itself. The prognosis of patients at the same stage receiving the same treatment varies greatly. Therefore, another prognostic model, based on the TNM staging system combined with other prognosis factors, has been evaluated 4 ; however, this model was not validated and has limited clinical applicability. Therefore, in this study, we established and validated a nomogram for locoregionally advanced NPC patients who received intensity-modulated radiation therapy (IMRT) and chemotherapy. Results Baseline chara...

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Prognostic role of plasma Epstein-Barr virus DNA load for nasopharyngeal carcinoma: a meta-analysis

Cited by 48 publications

References 39 publications

HPV in Head and Neck Carcinomas: Different HPV Profiles in Oropharyngeal Carcinomas – Why?

HPV in Head and Neck Carcinomas: Different HPV Profiles in Oropharyngeal Carcinomas – Why?

Prognostic value of gross tumor regression and plasma Epstein Barr Virus DNA levels at the end of intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma

Prognostic Nomogram For Locoregionally Advanced Nasopharyngeal Carcinoma

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