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Image_2_Prognostic Value of Plasma Epstein-Barr Virus DNA Levels Pre- and Post-Neoadjuvant Chemotherapy in Patients With Nasopharyngeal Carcinoma.tif
In this study, we evaluated the prognostic value of the plasma levels of Epstein-Barr virus (EBV) DNA in patients with nasopharyngeal carcinoma (NPC) at different treatment stages.
MethodsWe retrospectively analyzed the Data of 206 patients with NPC. Pre-neoadjuvant chemotherapy (pre-NACT), post-NACT, post-radiotherapy, and post-treatment plasma EBV DNA levels were used to establish prognostic nomograms. The concordance index (C-index) and calibration curves were used to compare the prognostic accuracy of the nomograms. The results were confirmed in a validation cohort consisting of patients who were tested for EBV DNA levels at all four stages of treatment. The Kaplan-Meier method was used to calculate the progression-free survival (PFS) and overall survival (OS). Survival differences were calculated using the log-rank test.
ResultsEBV DNA-positive patients had worse 3-year PFS and 5-year OS than EBV DNA-negative patients; this was true for pre-NACT (PFS: 82.7% vs. 57.3%, P < 0.001; OS: 90.9% vs. 68.7%, P = 0.08) and post-NACT (PFS: 85.0% vs. 50.6%, P < 0.001; OS: 91.7% vs. 65.7%; P = 0.001) EBV DNA levels but not for post-radiotherapy (PFS: 72.2% vs. 60.9%, P = 0.192; OS: 73.1% vs. 77.2%, P = 0.472) or post-treatment (PFS: 77.3% vs. 59.2%, P = 0.063; OS: 77.5% vs. 79.7%, P = 0.644) levels. Nomograms combining pre-NACT and post-NACT EBV DNA levels had a superior prognostic ability than those of post-radiotherapy and post-treatment EBV DNA levels.
ConclusionPre-NACT EBV DNA levels combined with post-NACT EBV DNA levels can more reliably predict survival outcomes in patients with NPC.
History
References
- https://doi.org//10.3322/caac.21262
- https://doi.org//10.1200/jco.1998.16.4.1310
- https://doi.org//10.1634/theoncologist.2017-0577
- https://doi.org//10.1016/s1470-2045(11)70320-5
- https://doi.org//10.1056/NEJMoa1905287
- https://doi.org//10.1093/annonc/mdy249
- https://doi.org//10.6004/jnccn.2018.7270
- https://doi.org//10.1371/journal.pone.0161878
- https://doi.org//10.1093/annonc/mdz231
- https://doi.org//10.1093/clinchem/hvaa170
- https://doi.org//10.1038/s41392-020-0151-9
- https://doi.org//10.1016/j.canlet.2013.05.018
- https://doi.org//10.1002/ijc.32021
- https://doi.org//10.1016/j.radonc.2018.10.010
- https://doi.org//10.1016/j.ijrobp.2019.01.007
- https://doi.org//10.1002/ijc.32380
- https://doi.org//10.1016/j.ijrobp.2006.07.012
- https://doi.org//10.7150/jca.18124
- https://doi.org//10.1177/1758835919877729
- https://doi.org//10.1200/jco.2018.77.7847
- https://doi.org//10.1186/s40880-017-0256-x
- https://doi.org//10.1002/hed.26018
- https://doi.org//10.1093/jnci/djv291
- https://doi.org//10.7150/ijbs.24374
- https://doi.org//10.1038/s41467-019-11853-y
- https://doi.org//10.1177/1758835920932052
- https://doi.org//10.1002/ijc.31856
- https://doi.org//10.1002/cncr.31741
- https://doi.org//10.1093/annonc/mdu117
- https://doi.org//10.1002/cncr.30520
- https://doi.org//10.1038/srep24835
- https://doi.org//10.1093/jnci/djaa149
- https://doi.org//10.3727/096504020x16022401878096
- https://doi.org//10.1016/j.ijrobp.2015.08.003
- https://doi.org//10.7150/jca.20255
- https://doi.org//10.20892/j.issn.2095-3941.2020.0464
- https://doi.org//10.1016/j.radonc.2021.03.035
- https://doi.org//10.1002/ijc.32774
- https://doi.org//10.1002/cncr.28564
- https://doi.org//10.1002/cac2.12100
- https://doi.org//10.1200/jco.2005.02.6195
- https://doi.org//10.1182/blood-2004-07-2975