Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma
Abstract Background This study was performed to investigate whether long‐term monitoring of dynamic changes in plasma Epstein‐Barr virus (EBV) DNA could improve prognosis prediction of nasopharyngeal carcinoma (NPC). Materials and methods About 1077 nonmetastatic NPC patients were recruited to retro...
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doaj-a0412c5d94b74db391d4e8c003a0ae542021-02-22T07:32:51ZengWileyCancer Medicine2045-76342021-02-0110388389410.1002/cam4.3669Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinomaWanxia Li0Jing Chen1Bijun Liang2Zonghua Li3Junzheng Li4Xiaofei Yuan5Shuting Wu6Fangfang Zeng7Xinyu Peng8Yanfei Li9Juan Lu10Feipeng Zhao11Xiong Liu12Department of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaSchool of Traditional Chinese Medicine Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology 942 Hospital of the Chinese People's Liberation Army Yinchuan Ningxia ChinaDepartment of Otolaryngology‐Head and Neck Surgery Guangzhou Red Cross Hospital Jinan University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaDepartment of Otolaryngology‐Head and Neck Surgery The Affiliated Hospital of Southwest Medical University Southwest Medical University Luzhou Sichuan ChinaDepartment of Otolaryngology‐Head and Neck Surgery Nanfang Hospital Southern Medical University Guangzhou Guangdong ChinaAbstract Background This study was performed to investigate whether long‐term monitoring of dynamic changes in plasma Epstein‐Barr virus (EBV) DNA could improve prognosis prediction of nasopharyngeal carcinoma (NPC). Materials and methods About 1077 nonmetastatic NPC patients were recruited to retrospectively analyze the prognostic value of plasma EBV DNA load pretreatment and 3, 12, 24, and 36 months posttreatment. We also examined the prognostic value of dynamic changes in plasma EBV DNA at various time points. Results Patients with plasma EBV DNA load above optimal pre‐ and posttreatment cut‐offs had significantly worse five‐year progression‐free survival, distant metastasis‐free survival, locoregional relapse‐free survival, and overall survival (OS) at all‐time points, excluding only OS at 36 months posttreatment due to limited mortalities. Patients with persistently undetectable plasma EBV DNA at the first four time points had the best prognosis, followed by those with positive detection pretreatment and consistently negative detection posttreatment, those with negative detection pretreatment and positive detection at one time point posttreatment, and those with positive detection pretreatment and at one time point posttreatment, whereas patients with positive detection at ≥2 time points posttreatment had the worst prognosis. Cox proportional hazard models identified the dynamic change pattern as an independent prognostic factor, and receiver operating characteristic curve analysis demonstrated that the dynamic change at four time point was more valuable than any single time point for predicting disease progression, distant metastasis, locoregional relapse, and mortality. Conclusions Dynamic changes in plasma EBV DNA pre‐ and posttreatment could predict the long‐term survival outcome and provide accurate risk stratification in NPC.https://doi.org/10.1002/cam4.3669dynamic changeEBV DNAnasopharyngeal carcinomaplasmaprognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wanxia Li Jing Chen Bijun Liang Zonghua Li Junzheng Li Xiaofei Yuan Shuting Wu Fangfang Zeng Xinyu Peng Yanfei Li Juan Lu Feipeng Zhao Xiong Liu |
spellingShingle |
Wanxia Li Jing Chen Bijun Liang Zonghua Li Junzheng Li Xiaofei Yuan Shuting Wu Fangfang Zeng Xinyu Peng Yanfei Li Juan Lu Feipeng Zhao Xiong Liu Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma Cancer Medicine dynamic change EBV DNA nasopharyngeal carcinoma plasma prognosis |
author_facet |
Wanxia Li Jing Chen Bijun Liang Zonghua Li Junzheng Li Xiaofei Yuan Shuting Wu Fangfang Zeng Xinyu Peng Yanfei Li Juan Lu Feipeng Zhao Xiong Liu |
author_sort |
Wanxia Li |
title |
Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma |
title_short |
Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma |
title_full |
Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma |
title_fullStr |
Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma |
title_full_unstemmed |
Long‐term monitoring of dynamic changes in plasma EBV DNA for improved prognosis prediction of nasopharyngeal carcinoma |
title_sort |
long‐term monitoring of dynamic changes in plasma ebv dna for improved prognosis prediction of nasopharyngeal carcinoma |
publisher |
Wiley |
series |
Cancer Medicine |
issn |
2045-7634 |
publishDate |
2021-02-01 |
description |
Abstract Background This study was performed to investigate whether long‐term monitoring of dynamic changes in plasma Epstein‐Barr virus (EBV) DNA could improve prognosis prediction of nasopharyngeal carcinoma (NPC). Materials and methods About 1077 nonmetastatic NPC patients were recruited to retrospectively analyze the prognostic value of plasma EBV DNA load pretreatment and 3, 12, 24, and 36 months posttreatment. We also examined the prognostic value of dynamic changes in plasma EBV DNA at various time points. Results Patients with plasma EBV DNA load above optimal pre‐ and posttreatment cut‐offs had significantly worse five‐year progression‐free survival, distant metastasis‐free survival, locoregional relapse‐free survival, and overall survival (OS) at all‐time points, excluding only OS at 36 months posttreatment due to limited mortalities. Patients with persistently undetectable plasma EBV DNA at the first four time points had the best prognosis, followed by those with positive detection pretreatment and consistently negative detection posttreatment, those with negative detection pretreatment and positive detection at one time point posttreatment, and those with positive detection pretreatment and at one time point posttreatment, whereas patients with positive detection at ≥2 time points posttreatment had the worst prognosis. Cox proportional hazard models identified the dynamic change pattern as an independent prognostic factor, and receiver operating characteristic curve analysis demonstrated that the dynamic change at four time point was more valuable than any single time point for predicting disease progression, distant metastasis, locoregional relapse, and mortality. Conclusions Dynamic changes in plasma EBV DNA pre‐ and posttreatment could predict the long‐term survival outcome and provide accurate risk stratification in NPC. |
topic |
dynamic change EBV DNA nasopharyngeal carcinoma plasma prognosis |
url |
https://doi.org/10.1002/cam4.3669 |
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