Long-term clinical outcome in nasopharyngeal carcinoma patients with post-radiation persistently detectable plasma EBV DNA.

Abstract

PURPOSE:

To investigate the long-term clinical outcome of nasopharyngeal carcinoma (NPC) patients with persistently detectable plasma EBV (pEBV) DNA after curative radiotherapy (RT).

RESULTS:

The post-RT pEBV DNA levels were very lower copy number (median 21, interquartile range 8-206 copies/ml). After long-term follow-up, the relapse rate was 64.8%, the median time to progression 20 months, and 5-year overall survival (OS) 49.6%. Thirty-two of 39 (82.1%) patients with high viral load (≥ 100 copies/ ml) developed tumor relapse, whereas 57.0% (49/86) patients with low viral load (< 100 copies/ml) had tumor relapse (P = 0.0065). The 5-year OS rates were 20.5% and 62.9% for patients with viral load ≥ and < 100 copies/ml (median survival, 20 vs. 100 months; P < 0.0001). Patients who received adjuvant chemotherapy (AdjCT) experienced significant reduction in distant failures (66.2% vs. 31.6%; P = 0.0001) but similar locoregional recurrences (P = 0.2337). The 5-year OS rates were 69.4% for patients who received AdjCT compared with 33.2% for those of without AdjCT (median survival, 111 vs. 32 months; P < 0.0001).

METHODS:

We screened 931 newly diagnosed NPC patients who finished curative RT and found 125 patients (13.4%) with detectable pEBV DNA one week after RT. The clinical characteristics, treatment modality, subsequent failure patterns and survivals were analyzed.

CONCLUSIONS:

NPC patients with persistently detectable pEBV DNA after curative RT have a higher rate of treatment failure and poor survivals. Levels of the post-RT pEBV DNA and administration of AdjCT affect the final outcome significantly.

• Authors: Wen-Yi Wang, Tian-Yun Lin, Chih-Wen Twu, Hsiao-Hui Tsou, Po-Ju Lin, Yi-Chun Liu, Jing-Wen Huang, He-Yuan Hsieh, Jin-Ching Lin
• Journal: Oncotarget (Oncotarget) Vol. 7 Issue 27 Pg. 42608-42616 (Jul 05 2016) ISSN: 1949-2553 [Electronic] United States
• PMID: 27191654 (Publication Type: Journal Article)

Chemical References

• DNA, Viral

Topics

• Adult
• Carcinoma (blood, radiotherapy, virology)
• Chemotherapy, Adjuvant
• DNA, Viral (blood)
• Disease Progression
• Disease-Free Survival
• Epstein-Barr Virus Infections (blood)
• Female
• Follow-Up Studies
• Herpesvirus 4, Human
• Humans
• Male
• Middle Aged
• Nasopharyngeal Carcinoma
• Nasopharyngeal Neoplasms (blood, radiotherapy, virology)
• Neoplasm Recurrence, Local
• Prognosis
• Radiotherapy (methods)
• Recurrence
• Treatment Outcome
• Viral Load