在调强放射治疗时代，血浆爱泼斯坦-巴尔病毒DNA补充了鼻咽癌的TNM分类。
Plasma Epstein-Barr viral DNA complements TNM classification of nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy.
作者信息
Zhang Lu, Tang Lin-Quan, Chen Qiu-Yan, Liu Huai, Guo Shan-Shan, Liu Li-Ting, Guo Ling, Mo Hao-Yuan, Zhao Chong, Guo Xiang, Cao Ka-Jia, Qian Chao-Nan, Zeng Mu-Sheng, Shao Jian-Yong, Sun Ying, Ma Jun, Hong Ming-Huang, Mai Hai-Qiang
机构信息
Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China.
Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China.
出版信息
Oncotarget. 2016 Feb 2;7(5):6221-30. doi: 10.18632/oncotarget.6754.
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.
背景
本研究的目的是验证鼻咽癌（NPC）患者治疗前血浆爱泼斯坦-巴尔病毒脱氧核糖核酸（pEBV DNA）水平的预后价值，以在应用调强放射治疗（IMRT）技术的基础上补充TNM分类。
方法
对2007年1月至2010年12月在我院癌症中心接受IMRT治疗的1467例I-IVa-b期（M0）患者进行回顾性分析。比较不同分期和EBV DNA水平患者的生存率。
结果
不同分期和EBV DNA水平的结果分析显示，II-III期低EBV DNA水平患者的生存率与IVa-b期低EBV DNA患者相似（5年总生存率（OS），94.7%对92.9%（P = 0.141），无进展生存期（PFS），87.2%对89.0%（P = 0.685），无远处转移生存期（DMFS），93.5%对92.4%（P = 0.394），无局部区域复发生存期（LRFS），93.8%对96.3%（P = 0.523））。相反，II-III期高EBV DNA患者的生存率高于IVa-b期高EBV DNA患者（5年OS，82.7%对71.7%（P = 0.001），PFS，70.7%对66.2%（P = 0.047），DMFS，79.6%对74.8%（P = 0.066），LRFS，89.3%对87.6%（P = 0.425）），但低于IVa-b期低EBV DNA患者（5年OS，82.7%对92.9%（P = 0.025），PFS，70.7%对89.0%（P < 0.001），DMFS，79.6%对92.4%（P = 0.001），LRFS，89.3%对96.3%（P = 0.022））。
结论
在IMRT应用时代，pEBV DNA与TNM分期相结合时是NPC患者的一个强有力的预后因素。
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