Lixia Lu1, Jiaxin Li2, Chong Zhao1, Wenqiong Xue3, Fei Han1, Tang Tao4, Hui Chang1, Weihua Jia3, Taixiang Lu5. 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China. 2. Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou 510080, China. 3. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China. 4. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China. 5. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China. Electronic address: lutx@sysucc.org.cn.
Abstract
OBJECTIVES: To evaluate the prognostic effect of combining tumor volume with pre-treatment plasma Epstein-Barr virus DNA (EBV DNA) in patients treated with intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: A total of 180 consecutive NPC patients enrolled in this observational, prospective study and underwent IMRT. Tumor volume was delineated with IMRT planning system and plasma EBV DNA level was quantified by polymerized chain-reaction assay. The effects of tumor volume and EBV DNA level, either alone or in combination, on 5-year overall survival (OS) were cross-compared. RESULTS: The 5-year OS in patients with gross tumor volume of nasopharynx (GTVnx)⩽20cc and >20cc was significantly different (P=0.001). The 5-year OS in patients with EBV DNA <6800copies/mL and ⩾6800copies/mL was also significantly different (P<0.001). Based on the combination of GTVnx with EBV DNA, the 5-year OS in different subgroups was: low-risk (100%), intermediate-risk (87.8%, 95% CI: 70.6-95.2%) and high-risk (61.3%, 95% CI: 47.9-72.2%). Patients with small tumor volume and high EBV DNA level had a worse prognosis than those with large tumor and low EBV DNA level. Patients with low EBV DNA levels, and either small or large tumor volumes, had favorable prognosis. According to small or large tumor volume, patients with high EBV DNA level were divided into intermediaterisk and high-risk subgroups. CONCLUSION: Combining tumor volume with pre-treatment plasma EBV DNA level altered survival-risk definition for subgroups of NPC patients and this combination, more than individual factors alone, improved the accuracy of prognostic evaluation.
OBJECTIVES: To evaluate the prognostic effect of combining tumor volume with pre-treatment plasma Epstein-Barr virus DNA (EBV DNA) in patients treated with intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: A total of 180 consecutive NPCpatients enrolled in this observational, prospective study and underwent IMRT. Tumor volume was delineated with IMRT planning system and plasma EBV DNA level was quantified by polymerized chain-reaction assay. The effects of tumor volume and EBV DNA level, either alone or in combination, on 5-year overall survival (OS) were cross-compared. RESULTS: The 5-year OS in patients with gross tumor volume of nasopharynx (GTVnx)⩽20cc and >20cc was significantly different (P=0.001). The 5-year OS in patients with EBV DNA <6800copies/mL and ⩾6800copies/mL was also significantly different (P<0.001). Based on the combination of GTVnx with EBV DNA, the 5-year OS in different subgroups was: low-risk (100%), intermediate-risk (87.8%, 95% CI: 70.6-95.2%) and high-risk (61.3%, 95% CI: 47.9-72.2%). Patients with small tumor volume and high EBV DNA level had a worse prognosis than those with large tumor and low EBV DNA level. Patients with low EBV DNA levels, and either small or large tumor volumes, had favorable prognosis. According to small or large tumor volume, patients with high EBV DNA level were divided into intermediaterisk and high-risk subgroups. CONCLUSION: Combining tumor volume with pre-treatment plasma EBV DNA level altered survival-risk definition for subgroups of NPCpatients and this combination, more than individual factors alone, improved the accuracy of prognostic evaluation.
Authors: Paolo Gamba; Luigina Rota; C Abeni; Alessandra Huscher; Gabriele Saldi; Alberto Soregaroli; Elena Padolecchia; Fausto Zorzi; Mario Bignardi; Alberto Zaniboni Journal: Case Rep Oncol Date: 2018-05-17