Plasma Epstein-Barr Virus DNA Level Strongly Predicts Survival in Metastatic/Recurrent Nasopharyngeal Carcinoma Treated With Palliative Chemotherapy
Plasma Epstein-Barr Virus DNA Level Strongly Predicts Survival in Metastatic/Recurrent Nasopharyngeal Carcinoma Treated With Palliative Chemotherapy
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DOI：
10.1002/cncr.25932
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发表时间：
2011-08-15
期刊：
影响因子：
6.2
通讯作者：
Li, Yu-Hong
中科院分区：
文献类型：
--
作者：
An, Xin;Wang, Feng-Hua;Li, Yu-Hong
背景技术背景：血浆EB病毒（EBV）DNA被广泛用于非转移性鼻咽癌（NPC）的筛查、监测和复发预测。然而，关于血浆EBV DNA在转移性NPC中的效用的数据是罕见的。本研究旨在探讨血浆EBV DNA水平对姑息性化疗后转移/复发鼻咽癌患者预后的影响。方法：对127例经组织学证实的转移性/复发性NPC患者进行姑息性化疗，分别于基线和每个治疗周期开始时测定血浆EBV DNA水平。分析治疗前和治疗后血浆EBV DNA水平与生存和应答的相关性。结果：患者治疗前血浆EBV DNA水平较低（=中位数）。治疗后血浆EBV DNA水平下降至不可检测水平的患者与治疗后血浆EBV DNA水平持续可检测的患者相比，具有更好的生存率和更好的肿瘤反应。化疗1个周期后，治疗后血浆EBV DNA早期下降至检测不到的水平与生存率显著增加相关。治疗前血浆EBV DNA水平低和治疗后血浆EBV DNA检测不到的患者显示出良好的预后（5年总体生存率和无进展生存率分别为50.6%和21.7%）。结论：血浆EBV DNA对鼻咽癌转移/复发患者姑息化疗的预后有一定的预测价值。治疗前的血浆EBV DNA水平以及化疗后血浆EBV DNA的早期降低使得能够容易和早期区分将从继续治疗中获益的患者和将不从继续治疗中获益的患者。Cancer 2011;117：3750-7. (C)2011年美国癌症协会
BACKGROUND: Plasma Epstein-Barr virus (EBV) DNA is widely used in screening, monitoring, and prediction of relapse in nonmetastatic nasopharyngeal carcinoma (NPC). However, data regarding utility of plasma EBV DNA in metastatic NPC are rare. The current study was to test the prognostic implication of plasma EBV DNA level in metastatic/recurrent NPC patients treated with palliative chemotherapy. METHODS: Plasma EBV DNA level was measured at baseline and thereafter at the start of each treatment cycle in 127 histologically proven metastatic/recurrent NPC patients treated with palliative chemotherapy. Correlations of pre-treatment and post-treatment plasma EBV DNA levels to survival and response were analyzed. RESULTS: Patients with a low pre-treatment plasma EBV DNA level (= median). Patients with a post-treatment plasma EBV DNA decline to an undetectable level had better survival and better tumor response compared with those with a sustained detectable post-treatment plasma EBV DNA level. The early decrease of post-treatment plasma EBV DNA to an undetectable level after 1 cycle of chemotherapy was associated with significantly increased survival. Patients with low pre-treatment plasma EBV DNA level and undetectable post-treatment plasma EBV DNA showed a favorable prognosis (5-year overall and progression-free survival of 50.6% and 21.7%, respectively). CONCLUSIONS: Plasma EBV DNA is of predictive value for prognosis in metastatic/recurrent NPC patients undergoing palliative chemotherapy. The pre-treatment plasma EBV DNA level as well as the early decrease of plasma EBV DNA after chemotherapy enabled easy and early discrimination between patients who will and those who will not benefit from continued treatment. Cancer 2011;117:3750-7. (C) 2011 American Cancer Society.