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Conference Paper: 5-Year Results of the Prognostic Roles of Serial Post-Intensity-Modulated Radiation Therapy Undetectable Plasma EBV DNA for Non-Metastatic Nasopharyngeal Carcinoma

Title5-Year Results of the Prognostic Roles of Serial Post-Intensity-Modulated Radiation Therapy Undetectable Plasma EBV DNA for Non-Metastatic Nasopharyngeal Carcinoma
Authors
Issue Date2018
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
60th Annual Meeting of the Amercian Society for Radiation Oncology (ASTRO), San Antonio, TA, 21-24 October 2018. In International Journal of Radiation Oncology - Biology - Physics, 2018, v. 102 n. 3, suppl., p. S126-S127, abstract no. 261 How to Cite?
AbstractPurpose/Objective(s): We previously demonstrated that post-IMRT 8th week and 6th month undetectable plasma EBV DNA were significant prognostic factors of 3-year survival endpoints for non-metastatic NPC. We now presented our 5-year results. (NCT02476669). Materials/Methods: Patients with previously untreated non-metastatic NPC confirmed by PET-CT and MRI scans were prospectively recruited from 2010 to 2016. They all had plasma EBV DNA measured at baseline, and then 8 weeks and 6 months following IMRT with/without concurrent +/- adjunct chemotherapy. They were staged and treated based on the 7th edition TNM of AJCC/UICC Staging Classification. Covariates including age, sex, ACE-27, pretreatment LDH and plasma EBV DNA were analyzed by Cox regression for prognostic factors of progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). Results: A total of 518 patients were prospectively recruited. 71 (13.7%) patients received IMRT alone, while 90 (17.4%) and 357 (68.9%) received concurrent chemoradiation alone and concurrent chemoradiation followed by adjunct chemotherapy respectively. The median pretreatment plasma EBV DNA titers was 494 copies/ml (range 0-175000 copies/ml). After a median follow-up of 5.2 years, 38 (7.3%) and 21 (4.1%) patients still had detectable titers at 8 weeks and 6 months following IMRT. 5-year PFS, CSS and OS in the whole study population were 77.1%, 90.4% and 84.4% respectively. Patients with post-IMRT 8th week and 6th month undetectable plasma EBV DNA titers enjoyed longer 5-year survival endpoints (PFS 79.1% vs. 40.9%; CSS 93.8% vs. 58.8%; OS 85.7% vs. 55.3%; all p<0.001), which were also lengthened for those with post-IMRT 6th month undetectable titers (PFS 78.7% vs. 19.0%; CSS 93.4% vs. 39.7%; OS 85.5% vs. 37.5%; all p<0.001), compared to those who still had detectable titers at the corresponding time points. They are also the only prognostic factors of these endpoints in multivariable analyses (all p<0.001). Conclusion: Post-IMRT 8th week and 6th month undetectable plasma EBV DNA remained significant prognostic factors after 5 years of follow-up. Additional therapy may have to be considered for those who had persistently detectable plasma EBV DNA after IMRT.
Persistent Identifierhttp://hdl.handle.net/10722/265103
ISSN
2017 Impact Factor: 5.554
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, VHF-
dc.contributor.authorKwong, DLW-
dc.contributor.authorLeung, TW-
dc.contributor.authorChoi, CW-
dc.contributor.authorO'Sullivan, B-
dc.contributor.authorLai, V-
dc.contributor.authorTong, CC-
dc.contributor.authorLam, KO-
dc.contributor.authorNg, CY-
dc.contributor.authorChan, SY-
dc.contributor.authorHo, PYP-
dc.contributor.authorChan, WLW-
dc.contributor.authorLeung, DK-
dc.contributor.authorChan, SK-
dc.contributor.authorTsang, KC-
dc.contributor.authorKhong, PL-
dc.contributor.authorLuk, MY-
dc.contributor.authorLee, WMA-
dc.date.accessioned2018-11-20T02:00:12Z-
dc.date.available2018-11-20T02:00:12Z-
dc.date.issued2018-
dc.identifier.citation60th Annual Meeting of the Amercian Society for Radiation Oncology (ASTRO), San Antonio, TA, 21-24 October 2018. In International Journal of Radiation Oncology - Biology - Physics, 2018, v. 102 n. 3, suppl., p. S126-S127, abstract no. 261-
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/265103-
dc.description.abstractPurpose/Objective(s): We previously demonstrated that post-IMRT 8th week and 6th month undetectable plasma EBV DNA were significant prognostic factors of 3-year survival endpoints for non-metastatic NPC. We now presented our 5-year results. (NCT02476669). Materials/Methods: Patients with previously untreated non-metastatic NPC confirmed by PET-CT and MRI scans were prospectively recruited from 2010 to 2016. They all had plasma EBV DNA measured at baseline, and then 8 weeks and 6 months following IMRT with/without concurrent +/- adjunct chemotherapy. They were staged and treated based on the 7th edition TNM of AJCC/UICC Staging Classification. Covariates including age, sex, ACE-27, pretreatment LDH and plasma EBV DNA were analyzed by Cox regression for prognostic factors of progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). Results: A total of 518 patients were prospectively recruited. 71 (13.7%) patients received IMRT alone, while 90 (17.4%) and 357 (68.9%) received concurrent chemoradiation alone and concurrent chemoradiation followed by adjunct chemotherapy respectively. The median pretreatment plasma EBV DNA titers was 494 copies/ml (range 0-175000 copies/ml). After a median follow-up of 5.2 years, 38 (7.3%) and 21 (4.1%) patients still had detectable titers at 8 weeks and 6 months following IMRT. 5-year PFS, CSS and OS in the whole study population were 77.1%, 90.4% and 84.4% respectively. Patients with post-IMRT 8th week and 6th month undetectable plasma EBV DNA titers enjoyed longer 5-year survival endpoints (PFS 79.1% vs. 40.9%; CSS 93.8% vs. 58.8%; OS 85.7% vs. 55.3%; all p<0.001), which were also lengthened for those with post-IMRT 6th month undetectable titers (PFS 78.7% vs. 19.0%; CSS 93.4% vs. 39.7%; OS 85.5% vs. 37.5%; all p<0.001), compared to those who still had detectable titers at the corresponding time points. They are also the only prognostic factors of these endpoints in multivariable analyses (all p<0.001). Conclusion: Post-IMRT 8th week and 6th month undetectable plasma EBV DNA remained significant prognostic factors after 5 years of follow-up. Additional therapy may have to be considered for those who had persistently detectable plasma EBV DNA after IMRT.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp-
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physics-
dc.title5-Year Results of the Prognostic Roles of Serial Post-Intensity-Modulated Radiation Therapy Undetectable Plasma EBV DNA for Non-Metastatic Nasopharyngeal Carcinoma-
dc.typeConference_Paper-
dc.identifier.emailLee, VHF: vhflee@hku.hk-
dc.identifier.emailKwong, DLW: dlwkwong@hku.hk-
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hk-
dc.identifier.emailChoi, CW: hcchoi@hku.hk-
dc.identifier.emailLai, V: laiv@hku.hk-
dc.identifier.emailTong, CC: tccz01@hku.hk-
dc.identifier.emailLam, KO: lamkaon@hku.hk-
dc.identifier.emailNg, CY: ngchoryi@hku.hk-
dc.identifier.emailHo, PYP: pattyho@hku.hk-
dc.identifier.emailChan, WLW: winglok@hku.hk-
dc.identifier.emailKhong, PL: plkhong@hku.hk-
dc.identifier.emailLuk, MY: myluk@hkucc.hku.hk-
dc.identifier.emailLee, WMA: awmlee@hkucc.hku.hk-
dc.identifier.authorityLee, VHF=rp00264-
dc.identifier.authorityKwong, DLW=rp00414-
dc.identifier.authorityLai, V=rp01516-
dc.identifier.authorityLam, KO=rp01501-
dc.identifier.authorityChan, WLW=rp02541-
dc.identifier.authorityKhong, PL=rp00467-
dc.identifier.authorityLee, WMA=rp02056-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2018.06.315-
dc.identifier.hkuros296156-
dc.identifier.volume102-
dc.identifier.issue3, suppl.-
dc.identifier.spageS126, abstract no. 261-
dc.identifier.epageS127, abstract no. 261-
dc.identifier.isiWOS:000447811602510-
dc.publisher.placeUnited States-

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