Plasma EBV DNA Clearance Rate as a Novel Prognostic Marker for Metastatic/Recurrent Nasopharyngeal Carcinoma
Plasma EBV DNA Clearance Rate as a Novel Prognostic Marker for Metastatic/Recurrent Nasopharyngeal Carcinoma
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DOI：
10.1158/1078-0432.ccr-09-2796
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发表时间：
2010-02-01
影响因子：
11.5
通讯作者：
Lin, Jin-Ching
中科院分区：
文献类型：
--
作者：
Wang, Wen-Yi;Twu, Chih-Wen;Lin, Jin-Ching
目的：探讨血浆EB病毒DNA浓度和清除率对鼻咽癌转移/复发患者预后的影响。实验设计：30例复发鼻咽癌患者和4例初治转移性鼻咽癌患者，按照本院头颈部肿瘤研究组的共识指南进行治疗。先化疗，然后在适当的情况下进行局部放疗和口服维持化疗)。在化疗的第一个月采集了多个血浆样本。用实时定量聚合酶链式反应检测循环中EB病毒DNA浓度。计算血浆EBV DNA清除半衰值(t(1/2))。结果：治疗12周后，肿瘤完全缓解14例(41.2%)，部分缓解12例(35.3%)，稳定7例(20.6%)，进展1例(2.9%)。血浆EBV DNA浓度对预后预测无显著影响。血浆EBV DNA清除时间t(1/2)为1.85~28.29天，中位数为3.99天。血浆EBVDNA清除短t(1/2)患者的完全应答率和总存活率显著高于血浆EBVDNA清除长t(1/2)患者。多因素分析显示血浆EBV DNA清除率t(1/2)对患者生存率有显著影响。结论：化疗后1个月血浆EBV DNA清除率可预测肿瘤疗效和患者生存期。对于血浆EBVDNA转阴率较低的患者，可考虑早期改变化疗方案。临床癌症资源；16(3)；1016-24。(C)2010年AACR。
Purpose: To investigate the prognostic effect of the concentrations and clearance rates of plasma EBV DNA in metastatic/recurrent nasopharyngeal carcinoma (NPC).Experimental Design: Thirty relapsed and four previously nontreated metastatic NPC patients were treated according to the consensus guidelines of the head and neck cancer team in our hospital (i.v. chemotherapy first, followed by local irradiation boost and oral maintenance chemotherapy where applicable). Multiple plasma samples were collected during the first month of chemotherapy. Circulating EBV DNA concentrations were measured by a real-time quantitative PCR. The half-life values (t(1/2)) of plasma EBV DNA clearance were calculated. The associations between clinical outcome and plasma EBV DNA assays were analyzed.Results: Tumor response evaluated after 12 weeks of treatment showed 14 complete responses (41.2%), 12 partial responses (35.3%), 7 stable diseases (20.6%), and 1 progression disease (2.9%). The plasma EBV DNA concentrations have no significant effects on outcome prediction. The t(1/2) of plasma EBV DNA clearance ranged from 1.85 to 28.29 days (median, 3.99). Patients with a short t(1/2) of plasma EBV DNA clearance have significantly higher complete response rate and overall survival than those with long t(1/2). Multivariate analysis revealed a significant effect of the t(1/2) of plasma EBV DNA clearance on survival.Conclusions: The clearance rates of plasma EBV DNA during the first month of chemotherapy can predict tumor response and patient survival. Early change of chemotherapy regimen may be considered for patients with slow plasma EBV DNA clearance rate. Clin Cancer Res; 16(3); 1016-24. (C) 2010 AACR.