scholarly journals The plasma Epstein–Barr virus DNA level guides precision treatment for nasopharyngeal carcinoma in the intensity-modulated radiotherapy era: a large population-based cohort study from an endemic area

2018 ◽  
Vol 10 ◽  
pp. 175883591878233 ◽  
Author(s):  
Hu Liang ◽  
Xing Lv ◽  
Lin Wang ◽  
Yi-Shan Wu ◽  
Rui Sun ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Endemic Area ◽  
Epstein Barr Virus ◽  
Intensity Modulated Radiotherapy ◽  
Concurrent Chemotherapy ◽  
Free Survival ◽  
Barr Virus ◽  
Intensity Modulated ◽  
Ebv Dna ◽  
Epstein Barr

Background: In the intensity-modulated radiotherapy (IMRT) era, the survival benefit of concurrent chemotherapy for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) remains undetermined. This study aimed to evaluate the benefits of IMRT with concurrent chemotherapy compared with IMRT alone for LA-NPC patients with different plasma Epstein–Barr virus (EBV) DNA levels. Methods: Patients were identified from a prospectively maintained database in an endemic area between November 2002 and December 2013. Cox proportional hazards models, propensity score matching, and inverse probability weighting models were established for survival analysis. Stratification analysis was performed based on interaction effects analysis. Finally, sensitivity analysis was performed considering unmeasured confounders. Results: A total of 1357 eligible patients were enrolled (median follow up 62.4 months; range 3.5–155.8 months). No significant survival differences were observed between groups in the entire cohort. Notably, a significant interaction effect was observed between treatment regimens and EBV DNA levels. In patients with high EBV DNA levels (>4000 copies/ml), all three models showed that IMRT with concurrent chemotherapy significantly improved overall survival [hazard ratio (HR) 2.521, 95% confidence interval (CI) 1.218–5.216], disease-free survival (HR 2.168, 95% CI 1.349–3.483), and distant metastasis-free survival (HR 2.331, 95% CI 1.194–4.551) compared with IMRT alone. No differences were found in patients with low EBV DNA levels. Sensitivity analysis confirmed the robustness of the results. Conclusion: In the IMRT era, concurrent chemotherapy treatment of LA-NPC patients with high EBV DNA levels is reasonable. However, the optimal regimen for LA-NPC patients with low EBV DNA levels needs further validation in randomized clinical trials.

scholarly journals Epstein-Barr virus DNA in serum as an early prognostic marker in children and adolescents with Hodgkin lymphoma

2017 ◽  
Vol 1 (11) ◽  
pp. 681-684 ◽  
Author(s):  
Jennifer J. G. Welch ◽  
Cindy L. Schwartz ◽  
Meghan Higman ◽  
Lu Chen ◽  
Allen Buxton ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Epstein Barr Virus ◽  
Event Free Survival ◽  
Free Survival ◽  
Barr Virus ◽  
Key Points ◽  
Tumor Persistence ◽  
Ebv Dna ◽  
Epstein Barr ◽  
Initiation Of Therapy

Key Points EBV DNA in cell-free blood in patients with Hodgkin lymphoma correlated with the presence of virus in tumor. Persistence of EBV DNA in cell-free blood 1 week after initiation of therapy predicted inferior event-free survival.

scholarly journals Prognostic role of plasma Epstein-Barr virus DNA load for nasopharyngeal carcinoma: a meta-analysis

2017 ◽  
Vol 40 (1) ◽  
pp. 1 ◽  
Author(s):  
Ting-bo Liu ◽  
Zhi-hong Zheng ◽  
Jie Pan ◽  
Li-li Pan ◽  
Li-hong Chen
Keyword(s):  
Distant Metastasis ◽  
Epstein Barr Virus ◽  
Meta Analysis ◽  
Newly Diagnosed ◽  
Free Survival ◽  
Barr Virus ◽  
Distant Metastasis Free Survival ◽  
Ebv Dna ◽  
Epstein Barr ◽  
Disease Free

Purpose: Predicting prognosis and treatment outcomes for patients with for nasopharyngeal carcinoma (NPC) has been difficult due to the heterogeneous nature of the disease This study aimed to evaluate pretreatment copy number of plasma Epstein-Barr virus (EBV) DNA as an outcome marker for survival in NPC. Methods: MEDLINE, CENTRAL and Embase databases were searched until April 7, 2015. Included studies were randomized controlled trials, two-arm prospective studies, or retrospective studies in patients with newly diagnosed NPC. The primary outcome was overall survival and secondary outcomes were progression-free, relapse-free, disease-free and distant metastasis-free survival. Sensitivity, quality and publication bias assessments were performed. Results: Sixteen studies were included in the meta-analysis, with a total of 7698 patients. For overall survival, pooled HR was 3.005 (95% confidence interval [CI] = 2.245–4.022; P < 0.001), indicating that higher levels of EBV DNA were associated with a greater risk of death. Pooled estimates for relapse-free, disease-free, progression-free and distant metastasis-free survival indicated that higher levels of EBV DNA were associated with an increased risk of relapse, disease recurrence, disease progression and distant metastasis in comparison with lower levels of EBV DNA (P values < 0.001). Conclusion: This meta-analysis found that high EBV DNA levels indicate poor prognosis and reduced long-term survival in patients with newly diagnosed NPC; hence, EBV DNA levels are highly prognostic of survival in patients with NPC. None of the included studies used the WHO standard for EBV DNA measurement, indicating a greater need for harmonization in future studies.

scholarly journals Intralesional EBV-DNA load as marker of prognosis for nasopharyngeal cancer

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Johan S. Nilsson ◽  
Ola Forslund ◽  
Fredrik C. Andersson ◽  
Malin Lindstedt ◽  
Lennart Greiff
Keyword(s):  
Epstein Barr Virus ◽  
Nasopharyngeal Cancer ◽  
Disease Free Survival ◽  
Curative Intent ◽  
Free Survival ◽  
Barr Virus ◽  
Stage Disease ◽  
Hpv Status ◽  
Ebv Dna ◽  
Epstein Barr

Abstract Nasopharyngeal cancer (NPC) is associated with the Epstein-Barr virus (EBV). The clinical presentation and prognosis of NPC is well described, but not in relation to intralesional EBV-DNA load. In a retrospective design, 48 patients with NPC were examined. Patient history was re-evaluated, and diagnostic biopsies were re-examined. Furthermore, intralesional EBV-DNA was quantitated and HPV status determined. Cancer stage, disease-free survival (DFS), and overall survival (OS) were assessed. Of the 48 patients, 36 (75%) patients featured lesions that were positive for EBER (Epstein–Barr virus-encoded small RNA) and 40 (83%) were positive for EBV-DNA. Seven patients (15%) were HPV positive. The levels of EBV-DNA ranged from 0.0005 to 94617 copies/cell. An EBV-DNA load of more than 70 copies/cell was associated with a prolonged DFS for EBV-DNA positive patients treated with curative intent (p = 0.046). In conclusion, the EBV-DNA load in NPC lesions appears to vary greatly. For patients with EBV-DNA positive NPC treated with curative intent, an EBV-DNA load of more than 70 copies/cell is associated with a better outcome in terms of 7-year DFS.

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