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Article: Prognostication of Half-Life Clearance of Plasma EBV DNA in Previously Untreated Non-metastatic Nasopharyngeal Carcinoma Treated With Radical Intensity-Modulated Radiation Therapy
Title | Prognostication of Half-Life Clearance of Plasma EBV DNA in Previously Untreated Non-metastatic Nasopharyngeal Carcinoma Treated With Radical Intensity-Modulated Radiation Therapy |
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Authors | |
Keywords | nasopharyngeal carcinoma intensity-modulated radiation therapy plasma Epstein–Barr virus deoxyribonucleic acid half-life clearance prognostication |
Issue Date | 2020 |
Publisher | Frontiers Research Foundation. The Journal's web site is located at http://www.frontiersin.org/oncology |
Citation | Frontiers in Oncology, 2020, v. 10, p. article no. 1417 How to Cite? |
Abstract | Introduction: The prognostic role of plasma Epstein–Barr virus (EBV) DNA clearance when intensity-modulated radiotherapy (IMRT) and the 8th edition of American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM Staging Classification are fully implemented remains undeciphered. We investigated if its half-life clearance during radical treatment for non-metastatic nasopharyngeal carcinoma (NPC) was an early prognosticator.
Patients and methods: Patients with previously untreated non-metastatic NPC were prospectively treated with radical IMRT and concurrent chemotherapy +/– induction/adjuvant chemotherapy from 2014 to 2018. Their plasma EBV DNA was measured immediately before treatment followed by weekly schedules until 0 copy/ml in two consecutive measurements. Cox regression models were employed to identify prognostic factors.
Results: Forty-five patients were prospectively recruited and analyzed. After a median follow-up of 30.3 months, 2 (4.5%), 1 (2.3%), and 6 (13.6%) patients experienced local, regional, and distant relapses, respectively. The median half-life clearance of plasma EBV DNA was 7.92 days. Those with half-life clearance of >15 days had a worse 3-years progression-free survival (PFS) (79.5 vs. 25.0%, p = 0.005), distant metastasis-free survival (DMFS) (85.0 vs. 31.3%, p = 0.009), and overall survival (OS) (91.3 vs. 75.0%, p = 0.024) when compared to those with a shorter half-life. Multivariable analyses demonstrated that only half-life (>15 days) was prognostic of DMFS [HR (95% CI): 4.91 (1.31; 18.39), p = 0.01] and OS [HR (95% CI): 5.24 (1.06; 26.05)] while half-life (>15 days) [HR (95% CI): 5.14 (1.28; 22.73), p = 0.02] and sum of pretreatment gross tumor volumes of the primary nasopharyngeal tumor and the radiologically positive neck nodes (GTV_P+N) [HR (95% CI): 1.01 (1.00; 1.03), p = 0.02] were prognostic of PFS.
Conclusion: The half-life clearance of plasma EBV DNA was prognostic in non-metastatic NPC staged and treated in the contemporary era. Earlier biomarker surveillance during treatment should be considered.
Clinical Trial Registration: This study has been registered with ClinicalTrials.gov (Identifier: NCT03830996). |
Persistent Identifier | http://hdl.handle.net/10722/287272 |
ISSN | 2023 Impact Factor: 3.5 2023 SCImago Journal Rankings: 1.066 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chan, SK | - |
dc.contributor.author | Chan, SY | - |
dc.contributor.author | Choi, HCW | - |
dc.contributor.author | Tong, CC | - |
dc.contributor.author | Lam, KO | - |
dc.contributor.author | Kwong, DLW | - |
dc.contributor.author | Vardhanabhuti, V | - |
dc.contributor.author | Leung, TW | - |
dc.contributor.author | Luk, MY | - |
dc.contributor.author | Lee, AWM | - |
dc.contributor.author | Lee, VHF | - |
dc.date.accessioned | 2020-09-22T02:58:27Z | - |
dc.date.available | 2020-09-22T02:58:27Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Frontiers in Oncology, 2020, v. 10, p. article no. 1417 | - |
dc.identifier.issn | 2234-943X | - |
dc.identifier.uri | http://hdl.handle.net/10722/287272 | - |
dc.description.abstract | Introduction: The prognostic role of plasma Epstein–Barr virus (EBV) DNA clearance when intensity-modulated radiotherapy (IMRT) and the 8th edition of American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM Staging Classification are fully implemented remains undeciphered. We investigated if its half-life clearance during radical treatment for non-metastatic nasopharyngeal carcinoma (NPC) was an early prognosticator. Patients and methods: Patients with previously untreated non-metastatic NPC were prospectively treated with radical IMRT and concurrent chemotherapy +/– induction/adjuvant chemotherapy from 2014 to 2018. Their plasma EBV DNA was measured immediately before treatment followed by weekly schedules until 0 copy/ml in two consecutive measurements. Cox regression models were employed to identify prognostic factors. Results: Forty-five patients were prospectively recruited and analyzed. After a median follow-up of 30.3 months, 2 (4.5%), 1 (2.3%), and 6 (13.6%) patients experienced local, regional, and distant relapses, respectively. The median half-life clearance of plasma EBV DNA was 7.92 days. Those with half-life clearance of >15 days had a worse 3-years progression-free survival (PFS) (79.5 vs. 25.0%, p = 0.005), distant metastasis-free survival (DMFS) (85.0 vs. 31.3%, p = 0.009), and overall survival (OS) (91.3 vs. 75.0%, p = 0.024) when compared to those with a shorter half-life. Multivariable analyses demonstrated that only half-life (>15 days) was prognostic of DMFS [HR (95% CI): 4.91 (1.31; 18.39), p = 0.01] and OS [HR (95% CI): 5.24 (1.06; 26.05)] while half-life (>15 days) [HR (95% CI): 5.14 (1.28; 22.73), p = 0.02] and sum of pretreatment gross tumor volumes of the primary nasopharyngeal tumor and the radiologically positive neck nodes (GTV_P+N) [HR (95% CI): 1.01 (1.00; 1.03), p = 0.02] were prognostic of PFS. Conclusion: The half-life clearance of plasma EBV DNA was prognostic in non-metastatic NPC staged and treated in the contemporary era. Earlier biomarker surveillance during treatment should be considered. Clinical Trial Registration: This study has been registered with ClinicalTrials.gov (Identifier: NCT03830996). | - |
dc.language | eng | - |
dc.publisher | Frontiers Research Foundation. The Journal's web site is located at http://www.frontiersin.org/oncology | - |
dc.relation.ispartof | Frontiers in Oncology | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | nasopharyngeal carcinoma | - |
dc.subject | intensity-modulated radiation therapy | - |
dc.subject | plasma Epstein–Barr virus deoxyribonucleic acid | - |
dc.subject | half-life clearance | - |
dc.subject | prognostication | - |
dc.title | Prognostication of Half-Life Clearance of Plasma EBV DNA in Previously Untreated Non-metastatic Nasopharyngeal Carcinoma Treated With Radical Intensity-Modulated Radiation Therapy | - |
dc.type | Article | - |
dc.identifier.email | Choi, HCW: hcchoi@hku.hk | - |
dc.identifier.email | Tong, CC: tccz01@hku.hk | - |
dc.identifier.email | Lam, KO: lamkaon@hku.hk | - |
dc.identifier.email | Kwong, DLW: dlwkwong@hku.hk | - |
dc.identifier.email | Vardhanabhuti, V: varv@hku.hk | - |
dc.identifier.email | Leung, TW: ltw920@hkucc.hku.hk | - |
dc.identifier.email | Luk, MY: myluk@hkucc.hku.hk | - |
dc.identifier.email | Lee, AWM: awmlee@hkucc.hku.hk | - |
dc.identifier.email | Lee, VHF: vhflee@hku.hk | - |
dc.identifier.authority | Lam, KO=rp01501 | - |
dc.identifier.authority | Kwong, DLW=rp00414 | - |
dc.identifier.authority | Vardhanabhuti, V=rp01900 | - |
dc.identifier.authority | Lee, AWM=rp02056 | - |
dc.identifier.authority | Lee, VHF=rp00264 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.3389/fonc.2020.01417 | - |
dc.identifier.pmid | 32974150 | - |
dc.identifier.pmcid | PMC7472777 | - |
dc.identifier.scopus | eid_2-s2.0-85090395276 | - |
dc.identifier.hkuros | 314399 | - |
dc.identifier.volume | 10 | - |
dc.identifier.spage | article no. 1417 | - |
dc.identifier.epage | article no. 1417 | - |
dc.identifier.isi | WOS:000568425800001 | - |
dc.publisher.place | Switzerland | - |
dc.identifier.issnl | 2234-943X | - |