Hopkins criteria for residual disease assessment after definitive radiotherapy in nasopharyngeal carcinoma.
Adolescent
Adult
Aged
Aged, 80 and over
Child
DNA, Viral
/ isolation & purification
Disease-Free Survival
Epstein-Barr Virus Infections
/ blood
Female
Follow-Up Studies
Herpesvirus 4, Human
/ genetics
Humans
Male
Middle Aged
Nasopharyngeal Carcinoma
/ diagnosis
Nasopharyngeal Neoplasms
/ diagnosis
Nasopharynx
/ diagnostic imaging
Neoplasm Recurrence, Local
/ epidemiology
Neoplasm, Residual
Positron Emission Tomography Computed Tomography
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Young Adult
Epstein-Barr virus
PET/CT
nasopharyngeal carcinoma
prognosis
response assessment
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
17
09
2019
revised:
04
12
2019
accepted:
05
12
2019
pubmed:
26
12
2019
medline:
24
4
2021
entrez:
26
12
2019
Statut:
ppublish
Résumé
Assessment of viable tumor residue after definitive radiotherapy is essential in patients with nasopharyngeal carcinoma (NPC). This study aimed to investigate the use of Hopkins criteria on positron emission tomography/computed tomography (PET/CT) for posttreatment response evaluation and whether plasma Epstein-Barr virus (EBV) DNA could bring additional value. NPC patients who underwent FDG-PET/CT scan within 26 weeks after definitive radiotherapy were retrospectively reviewed. Residual disease was evaluated by Hopkins 5-point score. Accuracy of Hopkins criteria before and after incorporating EBV DNA was calculated. Prognostic value for locoregional failure-free survival (LRFFS) and disease-free survival (DFS) was analyzed. One hundred and sixteen patients were evaluated. Median follow-up time was 28.3 months (range 3.3-92.0 months). Residual disease was found in 19 (16.4%) patients. Overall, Hopkins criteria had high specificity (86.6%; 95% CI, 78.2%-92.7%) and negative prognostic value (NPV) (94.4%; 95% CI, 88.7%-97.3%), while sensitivity and positive prognostic value (PPV) was 73.7% (95% CI, 48.8%-90.9%), 51.9% (95% CI, 37.8%-65.6%), respectively. Posttreatment plasma EBV DNA was not predictive of residual tumor (P = .272). PPV and accuracy were 50.0% (95% CI, 32.1%-67.9%) and 83.0% (95% CI, 73.8%-90.0%) after incorporating detectable EBV DNA into the scoring system. Positive PET/CT results were significantly correlated with inferior 3-year LRFFS (95.7% vs 79.5%, P = .043) and 3-year DFS (84.6% vs 54.4%, P = .028). The Hopkins criteria demonstrated high NPV and specificity in posttreatment assessment, with the potential to be a reliable prognostic indicator for locoregional failure. Combining EBV DNA with PET/CT did not improve diagnostic accuracies. PET/CT should not be performed less than 12 weeks after treatment.
Identifiants
pubmed: 31875356
doi: 10.1002/cam4.2790
pmc: PMC7013062
doi:
Substances chimiques
DNA, Viral
0
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1328-1334Informations de copyright
© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
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