Is pretreatment Epstein-Barr virus DNA still associated with 6-year survival outcomes in locoregionally advanced nasopharyngeal carcinoma?

作者：Ya-Nan Jin, Ji‐Jin Yao, Fan Zhang, Si-Yang Wang, Wangjian Zhang, Guan‐Qun Zhou, Zhen-Yu Qi, Ying Sun · 发表于：Journal of Cancer · 年份：2017 · DOI：10.7150/jca.18124 · 被引用次数：53 · 研究领域：Head and Neck Cancer Studies、Viral-associated cancers and disorders、Cancer-related molecular mechanisms research

Purpose: The objective of this study was to confirm the association between pretreatment Epstein-Barr virus (EBV) DNA (pre-DNA) load and survival outcomes after long-term follow-up in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC).Materials and Methods: Between November 2009 and February 2012, a total of 1036 patients with LA-NPC were enrolled.There were 762 patients in stage III and 274 in stage IVA-B.All patients were treated with radical radiotherapy with or without chemotherapy, and pre-DNA concentrations were quantified by a polymerase chain reaction assay.Patient outcomes were evaluated. Results:The 5-year overall survival (OS), distant metastasis-free surviva (DMFS), locoregional relapse-free survival (LRFS), and progression-free survival (PFS) rates were 84.7%, 87.0%, 90.2%, and 77.1%, respectively.By using previously defined pre-DNA cutoff value (1500 copies/ml pretreatment), pre-DNA was an independent prognostic predictor for OS, DMFS, and PFS using log-rank test.Multivariate Cox analysis also confirmed these results.Subgroup analysis indicated that the 5-year OS, DMFS, and PFS rates in patients staged IVA-B with pre-DNA < 1500 copies/ml were similar to those patients staged III with pre-DNA ≥ 1500 copies/ml, whereas patients staged IVA-B patients with pre-DNA ≥ 1500 copies/ml predicted worse outcome. Conclusions:In this expanded study, the prognostic significance of pre-DNA was confirmed using predefined cutoff value in an independent patie...