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Article: Prognostication of serial post-intensity-modulated radiation therapy undetectable plasma EBV DNA for nasopharyngeal carcinoma

TitlePrognostication of serial post-intensity-modulated radiation therapy undetectable plasma EBV DNA for nasopharyngeal carcinoma
Authors
KeywordsIntensity-modulated radiation therapy
Nasopharyngeal carcinoma
Non-metastatic
Plasma EBV DNA
Prognostic factors
Issue Date2017
PublisherImpact Journals LLC. The Journal's web site is located at http://www.impactjournals.com/oncotarget/index.html
Citation
Oncotarget, 2017, v. 8 n. 3, p. 5292-5308 How to Cite?
AbstractPlasma Epstein-Barr virus (EBV) DNA titers have been used to monitor treatment response and provide prognostic information on survival for nasopharyngeal carcinoma (NPC). However, the long-term prognostic role of pretreatment and posttreatment titers after radical contemporaneous radiation therapy remains uncertain. We recruited 260 evaluable patients with non-metastatic NPC treated with radical intensity-modulated radiation therapy (IMRT) with or without adjunct chemotherapy. Plasma EBV DNA titers at baseline and then 8 weeks and 6 months after IMRT were measured. Cox regression models were employed to identify interaction between post-IMRT 8th week and 6th month undetectable titers and 3-year survival endpoints. Concordance indices (Ct) from time-dependent receiver-operating characteristics (TDROC) were compared between patients with post-IMRT undetectable and those with detectable titers. After a median follow-up duration of 3.4 years (range 1.4-4.6 years), patients with post-IMRT 8th week and 6th month undetectable plasma EBV DNA titers enjoyed longer 3-year survival endpoints than those who had detectable titers at the same time points. Post-IMRT 8th week, and more significantly, post-IMRT 6th month undetectable plasma EBV DNA were the only significant prognostic factors of 3-year survival endpoints. Ct values for all 3-year survival endpoints for both post-IMRT 8th week and 6th month undetectable plasma EBV DNA were significantly higher in those with stage IVA–IVB diseases compared to stage I-III counterparts. Early post-IMRT undetectable plasma EBV DNA titers were prognostic of 3-year survival endpoints in patients with non-metastatic NPC. Intensified treatment should be further explored for patients with persistently detectable titers after IMRT.
Persistent Identifierhttp://hdl.handle.net/10722/239530
ISSN
2016 Impact Factor: 5.168
2023 SCImago Journal Rankings: 0.789
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, VHF-
dc.contributor.authorKwong, DLW-
dc.contributor.authorLeung, TW-
dc.contributor.authorChoi, CW-
dc.contributor.authorLai, V-
dc.contributor.authorNg, L-
dc.contributor.authorLam, KO-
dc.contributor.authorNg, CY-
dc.contributor.authorSze, CKH-
dc.contributor.authorTong, CC-
dc.contributor.authorHo, PYP-
dc.contributor.authorChan, WLW-
dc.contributor.authorWong, LS-
dc.contributor.authorKwok, CLD-
dc.contributor.authorChan, SY-
dc.contributor.authorKhong, PL-
dc.date.accessioned2017-03-21T09:15:24Z-
dc.date.available2017-03-21T09:15:24Z-
dc.date.issued2017-
dc.identifier.citationOncotarget, 2017, v. 8 n. 3, p. 5292-5308-
dc.identifier.issn1949-2553-
dc.identifier.urihttp://hdl.handle.net/10722/239530-
dc.description.abstractPlasma Epstein-Barr virus (EBV) DNA titers have been used to monitor treatment response and provide prognostic information on survival for nasopharyngeal carcinoma (NPC). However, the long-term prognostic role of pretreatment and posttreatment titers after radical contemporaneous radiation therapy remains uncertain. We recruited 260 evaluable patients with non-metastatic NPC treated with radical intensity-modulated radiation therapy (IMRT) with or without adjunct chemotherapy. Plasma EBV DNA titers at baseline and then 8 weeks and 6 months after IMRT were measured. Cox regression models were employed to identify interaction between post-IMRT 8th week and 6th month undetectable titers and 3-year survival endpoints. Concordance indices (Ct) from time-dependent receiver-operating characteristics (TDROC) were compared between patients with post-IMRT undetectable and those with detectable titers. After a median follow-up duration of 3.4 years (range 1.4-4.6 years), patients with post-IMRT 8th week and 6th month undetectable plasma EBV DNA titers enjoyed longer 3-year survival endpoints than those who had detectable titers at the same time points. Post-IMRT 8th week, and more significantly, post-IMRT 6th month undetectable plasma EBV DNA were the only significant prognostic factors of 3-year survival endpoints. Ct values for all 3-year survival endpoints for both post-IMRT 8th week and 6th month undetectable plasma EBV DNA were significantly higher in those with stage IVA–IVB diseases compared to stage I-III counterparts. Early post-IMRT undetectable plasma EBV DNA titers were prognostic of 3-year survival endpoints in patients with non-metastatic NPC. Intensified treatment should be further explored for patients with persistently detectable titers after IMRT.-
dc.languageeng-
dc.publisherImpact Journals LLC. The Journal's web site is located at http://www.impactjournals.com/oncotarget/index.html-
dc.relation.ispartofOncotarget-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectIntensity-modulated radiation therapy-
dc.subjectNasopharyngeal carcinoma-
dc.subjectNon-metastatic-
dc.subjectPlasma EBV DNA-
dc.subjectPrognostic factors-
dc.titlePrognostication of serial post-intensity-modulated radiation therapy undetectable plasma EBV DNA for nasopharyngeal carcinoma-
dc.typeArticle-
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.emailLam, KO: lamkaon@hku.hk-
dc.identifier.emailNg, CY: ngchoryi@hku.hk-
dc.identifier.emailSze, CKH: henrysze@graduate.hku.hk-
dc.identifier.emailTong, CC: tccz01@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.authorityLee, VHF=rp00264-
dc.identifier.authorityKwong, DLW=rp00414-
dc.identifier.authorityLai, V=rp01516-
dc.identifier.authorityLam, KO=rp01501-
dc.identifier.authoritySze, CKH=rp01697-
dc.identifier.authorityChan, WLW=rp02541-
dc.identifier.authorityKhong, PL=rp00467-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.18632/oncotarget.14137-
dc.identifier.pmid28029657-
dc.identifier.pmcidPMC5354909-
dc.identifier.scopuseid_2-s2.0-85012034054-
dc.identifier.hkuros271597-
dc.identifier.volume8-
dc.identifier.issue3-
dc.identifier.spage5292-
dc.identifier.epage5308-
dc.identifier.isiWOS:000393228400123-
dc.publisher.placeUnited States-
dc.identifier.issnl1949-2553-

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