Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Feb 2;7(5):6221-30.
doi: 10.18632/oncotarget.6754.

Plasma Epstein-Barr viral DNA complements TNM classification of nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy

Lu Zhang  1   2 , Lin-Quan Tang  1   2 , Qiu-Yan Chen  1   2 , Huai Liu  3   4   5 , Shan-Shan Guo  1   2 , Li-Ting Liu  1   2 , Ling Guo  1   2 , Hao-Yuan Mo  1   2 , Chong Zhao  1   2 , Xiang Guo  1   2 , Ka-Jia Cao  1   2 , Chao-Nan Qian  1   2 , Mu-Sheng Zeng  1 , Jian-Yong Shao  1   6 , Ying Sun  1   7 , Jun Ma  1   7 , Ming-Huang Hong  1   8 , Hai-Qiang Mai  1   2
Affiliations

Plasma Epstein-Barr viral DNA complements TNM classification of nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy

Lu Zhang et al. Oncotarget. .

Abstract

Background: The objective of this study is to verify the prognostic value of pretreatment plasma Epstein-Barr viral deoxyribonucleic acid (pEBV DNA) levels in nasopharyngeal carcinoma (NPC) patients to complement TNM classification based on the application of the intensity-modulated radiotherapy (IMRT) technique.

Methods: In total, 1467 patients staged at I-IVa-b (M0) and treated with IMRT were retrospectively analyzed at our cancer center from January 2007 to December 2010. Patient survival among different stages and EBV DNA levels were compared.

Results: Outcome analyses of different stages and EBV DNA levels revealed that patients in stages II-III with low EBV DNA levels had similar survival as that of patients in stages IVa-b with low EBV DNA (5-yr overall survival (OS), 94.7% vs. 92.9% (P = 0.141), progression failure-free survival (PFS), 87.2% vs. 89.0% (P = 0.685), distant metastasis failure-free survival (DMFS), 93.5% vs. 92.4% (P = 0.394) and locoregional failure-free survival (LRFS), 93.8% vs. 96.3% (P = 0.523)). Conversely, patients in stages II-III with high EBV DNA had better survival than patients in stages IVa-b with high EBV DNA (5-yr OS, 82.7% vs. 71.7% (P = 0.001), PFS, 70.7% vs. 66.2% (P = 0.047), DMFS, 79.6% vs. 74.8% (P = 0.066) and LRFS, 89.3% vs. 87.6% (P = 0.425)) but poorer survival than patients in stages IVa-b with low EBV DNA (5-yr OS, 82.7% vs. 92.9% (P = 0.025), PFS, 70.7% vs. 89.0, (P < 0.001), DMFS, 79.6% vs. 92.4%, (P = 0.001), LRFS, 89.3% vs. 96.3%, (P = 0.022)).

Conclusions: pEBV DNA is a strong prognostic factor for patients with NPC when complemented with TNM staging in the era of IMRT application.

Keywords: Epstein-Barr viral DNA; TNM staging; intensity-modulated radiotherapy; nasopharyngeal carcinoma; prognosis.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier curves for overall survival (A), progression-free survival (B), distant metastasis failure-free survival (C) and locoregional failure-free survival (D) in NPC patients at different stages.
Figure 2
Figure 2
Kaplan-Meier curves for overall survival (A), progression-free survival (B), distant metastasis failure-free survival (C) and locoregional failure-free survival (D) in NPC patients of different groups (group 1, stage I; group 2, stages II–III; group 3, stages IVa–b).
Figure 3
Figure 3
Kaplan-Meier curves for overall survival (A), progression-free survival (B), distant metastasis failure-free survival (C) and locoregional failure-free survival (D) for the entire cohort according to EBV DNA levels. A low EBV DNA denotes an EBV DNA concentration < 4000 copies/ml, and a high EBV DNA denotes an EBV DNA concentration ≥ 4000 copies/ml.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Shin HR, Masuyer E, Ferlay J, Curado MP. Cancer in Asia - Incidence rates based on data in cancer incidence in five continents IX (1998–2002) Asian Pac J Cancer Prev. 2010;11:11–16. - PubMed
    1. Mao YP, Xie FY, Liu LZ, Sun Y, Li L, Tang LL, Liao XB, Xu HY, Chen L, Lai SZ, Lin AH, Liu MZ, Ma J. Re-evaluation of 6th edition of AJCC staging system for nasopharyngeal carcinoma and proposed improvement based on magnetic resonance imaging. Int J Radiat Oncol Biol Phys. 2009;73:1326–1334. - PubMed
    1. Wang HY, Sun BY, Zhu ZH, Chang ET, To KF, Hwang JS, Jiang H, Kam MK, Chen G, Cheah SL, Lee M, Liu ZW, Chen J, et al. Eight-signature classifier for prediction of nasopharyngeal [corrected] carcinoma survival. J Clin Oncol. 2011;29:4516–4525. - PubMed
    1. Leung SF, Zee B, Ma BB, Hui EP, Mo F, Lai M, Chan KC, Chan LY, Kwan WH, Lo YM, Chan AT. Plasma Epstein-Barr viral deoxyribonucleic acid quantitation complements tumor-node-metastasis staging prognostication in nasopharyngeal carcinoma. J Clin Oncol. 2006;24:5414–5418. - PubMed
    1. Lin JC, Wang WY, Chen KY, Wei YH, Liang WM, Jan JS, Jiang RS. Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma. N Engl J Med. 2004;350:2461–2470. - PubMed

Publication types

MeSH terms

LinkOut - more resources