Section of Basic Medicine, Department of Nursing, Hung Kuang University, Taichung, Taiwan.
Cancer. 2013 Mar 1;119(5):963-70. doi: 10.1002/cncr.27853. Epub 2012 Oct 12.
The objective of this study was to confirm the relation between plasma Epstein-Barr virus (EBV) DNA (pEBV DNA) load and treatment outcomes after long-term follow-up in patients with nasopharyngeal carcinoma (NPC).
In total, 210 patients with NPC were enrolled, including 99 previously reported patients and 111 new patients. They prospectively received treatment with induction chemotherapy plus radiotherapy and were followed for at least 6 years. In these patients, pEBV DNA levels were measured before treatment and 1 week after treatment. The plasma viral load was correlated with treatment outcomes in the group of new patients and in the entire group.
By using previously defined pEBV DNA cutoff values (1500 copies/mL pretreatment and 0 copies/mL post-treatment), there was a significant correlation between the pEBV DNA value and relapse-free survival, overall survival, and subsequent relapse rates in the new, independent patient cohort. Outcome analyses for the entire group revealed a higher relapse rate (45.6% vs 21.5% [P = .0037] or 76.7% vs 26.1% [P < .0001]), a worse relapse-free survival rate (56.5% vs 79.3% [P < .0001] or 23.3% vs 75.6% [P < .0001]), and poorer overall survival (59.2% vs 86% [P = .0003] or 33.3% vs 79.4% [P < .0001]) in patients who had high pretreatment or persistently detectable post-treatment pEBV DNA levels, respectively, versus their respective counterparts. Multivariate Cox analysis also confirmed these results.
In this expanded study, the prognostic significance of pEBV DNA was confirmed using predefined cutoff values in an independent patient group, and pEBV DNA was identified as an independent prognostic marker for NPC.
本研究旨在通过长期随访，确认血浆 Epstein-Barr 病毒（EBV）DNA（pEBV DNA）载量与鼻咽癌（NPC）患者治疗结局之间的关系。
共纳入 210 例 NPC 患者，包括 99 例既往报道的患者和 111 例新患者。所有患者均前瞻性接受诱导化疗联合放疗，并至少随访 6 年。这些患者在治疗前和治疗后 1 周检测 pEBV DNA 水平。在新患者组和整个患者组中，血浆病毒载量与治疗结局相关。
使用之前定义的 pEBV DNA 截止值（治疗前 1500 拷贝/ml，治疗后 0 拷贝/ml），在新的独立患者队列中，pEBV DNA 值与无复发生存、总生存和随后的复发率之间存在显著相关性。对整个患者组进行的生存分析显示，高复发率（45.6%比 21.5%[P=0.0037]或 76.7%比 26.1%[P<.0001]）、无复发生存率较差（56.5%比 79.3%[P<.0001]或 23.3%比 75.6%[P<.0001]）和总体生存率较差（59.2%比 86%[P=0.0003]或 33.3%比 79.4%[P<.0001]），分别在治疗前高 pEBV DNA 或持续可检测治疗后 pEBV DNA 水平的患者中，与各自的对照相比。多变量 Cox 分析也证实了这些结果。
在这项扩展研究中，使用预设的临界值在独立患者组中证实了 pEBV DNA 的预后意义，并确定 pEBV DNA 是 NPC 的独立预后标志物。
