Long-Term Prognostic Effects of Plasma Epstein-Barr Virus DNA by Minor Groove Binder-Probe Real-Time Quantitative PCR on Nasopharyngeal Carcinoma Patients Receiving Concurrent Chemoradiotherapy

Journal Article · Wed Aug 01 00:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.02.012· OSTI ID:20953589

Lin, J -C ^[1]; Wang, W -Y ^[2]; Liang, W -M ^[3]; Chou, H -Y ^[4]; Jan, J -S ^[4]; Jiang, R -S ^[5]; Wang, J -Y ^[2]; Twu, C -W ^[5]; Liang, K -L ^[5]; Chao, Jeffrey ^[4]; Shen, W -C ^[6]

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1. Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan (China) and Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China) and Department of Medicine, School of Medicine, China Medical University, Taichung, Taiwan (China)
2. Section of Basic Medicine, Department of Nursing, Hung Kuang University, Taichung, Taiwan (China)
3. Department of Public Health, China Medical University, Taichung, Taiwan (China)
4. Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan (China)
5. Department of Otorhinolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan (China)
6. Department of Medicine, School of Medicine, China Medical University, Taichung, Taiwan (China)

Purpose: To evaluate the long-term prognostic impact of plasma Epstein-Barr virus (EBV) DNA concentration measured by real-time quantitative polymerase chain reaction (RTQ-PCR) in nasopharyngeal carcinoma (NPC) patients receiving concurrent chemoradiotherapy (CCRT). Methods and Materials: Epstein-Barr virus DNA was retrospectively measured from stock plasma of 152 biopsy-proven NPC patients with Stage II-IV (M0) disease with a RTQ-PCR using the minor groove binder-probe. All patients received CCRT with a median follow-up of 78 months. We divided patients into three subgroups: (1) low pretreatment EBV DNA (<1,500 copies/mL) and undetectable posttreatment EBV DNA (pre-L/post-U) (2) high pretreatment EBV DNA ({>=}1,500 copies/mL) and undetectable posttreatment EBV DNA (pre-H/post-U), and (3) low or high pretreatment EBV DNA and detectable posttreatment EBV DNA (pre-L or H/post-D) for prognostic analyses. Results: Epstein-Barr virus DNA (median concentration, 573 copies/mL; interquartile range, 197-3,074) was detected in the pretreatment plasma of 94.1% (143/152) of patients. After treatment, plasma EBV DNA decreased or remained 0 for all patients and was detectable in 31 patients (20.4%) with a median concentration 0 copy/mL (interquartile range, 0-0). The 5-year overall survival rates of the pre-L/post-U, pre-H/post-U, and pre-L or H/post-D subgroups were 87.2%, 71.0%, and 38.7%, respectively (p < 0.0001). The relapse-free survival showed similar results with corresponding rates of 85.6%, 75.9%, and 26.9%, respectively (p < 0.0001). Multivariate Cox analysis confirmed the superior effects of plasma EBV DNA compared to other clinical parameters in prognosis prediction. Conclusion: Plasma EBV DNA is the most valuable prognostic factor for NPC. More chemotherapy should be considered for patients with persistently detectable EBV DNA after CCRT.

• OSTI ID: 20953589
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 68, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2007.02.012; PII: S0360-3016(07)00315-X; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

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