Effects of Epstein-Barr virus viral load and different treatment modality for stage III nasopharyngeal carcinoma.
Epstein-Barr virus
chemoradiotherapy
nasopharyngeal carcinoma
plasma
stage III
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
20
08
2019
revised:
19
12
2019
accepted:
15
01
2020
pubmed:
6
2
2020
medline:
22
6
2021
entrez:
4
2
2020
Statut:
ppublish
Résumé
We investigated treatment results, the effects of different treatment modality, and pretreatment Epstein-Barr virus (EBV) viral load for stage III nasopharyngeal carcinoma (NPC) patients. The initial definitive treatment for 356 stage III NPC patients consisted of concurrent chemoradiotherapy (CCRT) or induction chemotherapy plus radiotherapy (IndCT-RT). The pretreatment EBV DNA level separated patients into a high (n = 106) or low (n = 250) viral load (≥ or < 1000 copies/mL) subgroup. Outcome measures include relapse rates and various survivals. The 5-year rates of overall survival (OS), progression-free survival (PFS), distant metastasis failure-free survival (DMFFS), and locoregional failure-free survival (LRFFS) were 88.6%, 83.0%, 90.5%, and 90.5%, respectively. Patient characteristics and pretreatment viral load between IndCT-RT and CCRT were no significant differences except for a higher percentage of N2 disease in the IndCT-RT subgroup. Both treatment modality resulted in similar relapse rates (P = .56), OS (P = .20), PFS (P = .53), DMFFS (P = .89), and LRFFS (P = .35). However, patients with a high viral load experienced a higher relapse rate (33.0% vs 12.4%, P < .001) and worse OS (5-year rate, 79.0% vs 92.8%, P < .001), PFS (73.7% vs 88.4%, P < .001), DMFFS (80.2% vs 95.0%, P < .001), and LRFFS (85.6% vs 92.6%, P = .005) than those with a low viral load. Long-term treatment results for stage III NPC patients are rather good. IndCT-RT can achieve the same treatment outcome as CCRT. Risk grouping by pretreatment viral load identified a subgroup (30%) of patients associated with a significantly higher relapse rates and worse survivals. These high-risk patients need to strengthen treatment intensity in future trials.
Sections du résumé
BACKGROUND
We investigated treatment results, the effects of different treatment modality, and pretreatment Epstein-Barr virus (EBV) viral load for stage III nasopharyngeal carcinoma (NPC) patients.
METHODS
The initial definitive treatment for 356 stage III NPC patients consisted of concurrent chemoradiotherapy (CCRT) or induction chemotherapy plus radiotherapy (IndCT-RT). The pretreatment EBV DNA level separated patients into a high (n = 106) or low (n = 250) viral load (≥ or < 1000 copies/mL) subgroup. Outcome measures include relapse rates and various survivals.
RESULTS
The 5-year rates of overall survival (OS), progression-free survival (PFS), distant metastasis failure-free survival (DMFFS), and locoregional failure-free survival (LRFFS) were 88.6%, 83.0%, 90.5%, and 90.5%, respectively. Patient characteristics and pretreatment viral load between IndCT-RT and CCRT were no significant differences except for a higher percentage of N2 disease in the IndCT-RT subgroup. Both treatment modality resulted in similar relapse rates (P = .56), OS (P = .20), PFS (P = .53), DMFFS (P = .89), and LRFFS (P = .35). However, patients with a high viral load experienced a higher relapse rate (33.0% vs 12.4%, P < .001) and worse OS (5-year rate, 79.0% vs 92.8%, P < .001), PFS (73.7% vs 88.4%, P < .001), DMFFS (80.2% vs 95.0%, P < .001), and LRFFS (85.6% vs 92.6%, P = .005) than those with a low viral load.
CONCLUSION
Long-term treatment results for stage III NPC patients are rather good. IndCT-RT can achieve the same treatment outcome as CCRT. Risk grouping by pretreatment viral load identified a subgroup (30%) of patients associated with a significantly higher relapse rates and worse survivals. These high-risk patients need to strengthen treatment intensity in future trials.
Substances chimiques
DNA, Viral
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1765-1774Informations de copyright
© 2020 Wiley Periodicals, Inc.
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