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Risk stratification for nasopharyngeal carcinoma: a real-world study based on locoregional extension patterns and Epstein-Barr virus DNA load
Aim: The present study aimed to evaluate the combined value of locoregional extension patterns (LEPs) and circulating cell-free Epstein–Barr virus (cf EBV) DNA for risk stratification of locoregionally advanced nasopharyngeal carcinoma (LA-NPC) to better guide therapeutic strategies. Methods: A tota...
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| Published in: | Therapeutic advances in medical oncology 2020, Vol.12, p.1758835920932052-1758835920932052 |
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| container_title | Therapeutic advances in medical oncology |
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| creator | Zhang, Lu-Lu Huang, Meng-Yao Fei-Xu Wang, Ke-Xin Song, Di Wang, Ting Sun, Li-Yue Shao, Jian-Yong |
| description | Aim:
The present study aimed to evaluate the combined value of locoregional extension patterns (LEPs) and circulating cell-free Epstein–Barr virus (cf EBV) DNA for risk stratification of locoregionally advanced nasopharyngeal carcinoma (LA-NPC) to better guide therapeutic strategies.
Methods:
A total of 7227 cases of LA-NPC were reviewed retrospectively and classified into six groups according to their LEP (ascending, descending, or mixed type) and pre-treatment cf EBV-DNA load (⩾ versus |
| doi_str_mv | 10.1177/1758835920932052 |
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The present study aimed to evaluate the combined value of locoregional extension patterns (LEPs) and circulating cell-free Epstein–Barr virus (cf EBV) DNA for risk stratification of locoregionally advanced nasopharyngeal carcinoma (LA-NPC) to better guide therapeutic strategies.
Methods:
A total of 7227 cases of LA-NPC were reviewed retrospectively and classified into six groups according to their LEP (ascending, descending, or mixed type) and pre-treatment cf EBV-DNA load (⩾ versus <4000 copy/ml). Using a supervised statistical clustering approach, patients in the six groups were clustered into low, intermediate, and high-risk clusters. Progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS) were calculated using the Kaplan–Meier method and differences were compared using the log-rank test.
Results:
Survival curves for the low, intermediate, and high-risk clusters were significantly different for all endpoints. The 5-year survival rate for the low, intermediate, and high-risk clusters, respectively, were: PFS (83.5%, 73.2%, 62.6%, p < 0.001), OS (91.0%, 82.7%, 73.2%, p < 0.001), DMFS (92.3%, 83.0%, 73.4%, p < 0.001), and LRRFS (91.0%, 88.0%, 83.3%, p < 0.001). The risk clusters acted as independent prognostic factors for all endpoints. Among the patients in the high-risk cluster, neoadjuvant chemotherapy combined with concurrent chemoradiotherapy (CCRT) significantly improved the patients 5-year PFS (66.4% versus 57.9%, p = 0.014), OS (77.6% versus 68.6%; p < 0.002), and DMFS (76.6% versus 70.6%; p = 0.028) compared with those treated with CCRT.
Conclusion:
Our results could facilitate the development of risk-stratification and risk-adapted therapeutic strategies for patients with LA-NPC.]]></description><identifier>ISSN: 1758-8359</identifier><identifier>ISSN: 1758-8340</identifier><identifier>EISSN: 1758-8359</identifier><identifier>DOI: 10.1177/1758835920932052</identifier><identifier>PMID: 32587634</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Chemoradiotherapy ; Chemotherapy ; Deoxyribonucleic acid ; DNA ; Epstein-Barr virus ; Medical prognosis ; Metastases ; Nasopharyngeal carcinoma ; Original Research ; Radiation therapy ; Throat cancer</subject><ispartof>Therapeutic advances in medical oncology, 2020, Vol.12, p.1758835920932052-1758835920932052</ispartof><rights>The Author(s), 2020</rights><rights>The Author(s), 2020.</rights><rights>The Author(s), 2020. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s), 2020 2020 SAGE Publications Ltd unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-92a3c0be9ff110d7e1e5773fc14a3991900ea92f1fe4b8b3cbfbf0f355e5f5bd3</citedby><cites>FETCH-LOGICAL-c528t-92a3c0be9ff110d7e1e5773fc14a3991900ea92f1fe4b8b3cbfbf0f355e5f5bd3</cites><orcidid>0000-0002-0171-908X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294474/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2429460634?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32587634$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Lu-Lu</creatorcontrib><creatorcontrib>Huang, Meng-Yao</creatorcontrib><creatorcontrib>Fei-Xu</creatorcontrib><creatorcontrib>Wang, Ke-Xin</creatorcontrib><creatorcontrib>Song, Di</creatorcontrib><creatorcontrib>Wang, Ting</creatorcontrib><creatorcontrib>Sun, Li-Yue</creatorcontrib><creatorcontrib>Shao, Jian-Yong</creatorcontrib><title>Risk stratification for nasopharyngeal carcinoma: a real-world study based on locoregional extension patterns and Epstein-Barr virus DNA load</title><title>Therapeutic advances in medical oncology</title><addtitle>Ther Adv Med Oncol</addtitle><description><![CDATA[Aim:
The present study aimed to evaluate the combined value of locoregional extension patterns (LEPs) and circulating cell-free Epstein–Barr virus (cf EBV) DNA for risk stratification of locoregionally advanced nasopharyngeal carcinoma (LA-NPC) to better guide therapeutic strategies.
Methods:
A total of 7227 cases of LA-NPC were reviewed retrospectively and classified into six groups according to their LEP (ascending, descending, or mixed type) and pre-treatment cf EBV-DNA load (⩾ versus <4000 copy/ml). Using a supervised statistical clustering approach, patients in the six groups were clustered into low, intermediate, and high-risk clusters. Progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS) were calculated using the Kaplan–Meier method and differences were compared using the log-rank test.
Results:
Survival curves for the low, intermediate, and high-risk clusters were significantly different for all endpoints. The 5-year survival rate for the low, intermediate, and high-risk clusters, respectively, were: PFS (83.5%, 73.2%, 62.6%, p < 0.001), OS (91.0%, 82.7%, 73.2%, p < 0.001), DMFS (92.3%, 83.0%, 73.4%, p < 0.001), and LRRFS (91.0%, 88.0%, 83.3%, p < 0.001). The risk clusters acted as independent prognostic factors for all endpoints. Among the patients in the high-risk cluster, neoadjuvant chemotherapy combined with concurrent chemoradiotherapy (CCRT) significantly improved the patients 5-year PFS (66.4% versus 57.9%, p = 0.014), OS (77.6% versus 68.6%; p < 0.002), and DMFS (76.6% versus 70.6%; p = 0.028) compared with those treated with CCRT.
Conclusion:
Our results could facilitate the development of risk-stratification and risk-adapted therapeutic strategies for patients with LA-NPC.]]></description><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>Epstein-Barr virus</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Nasopharyngeal carcinoma</subject><subject>Original Research</subject><subject>Radiation therapy</subject><subject>Throat cancer</subject><issn>1758-8359</issn><issn>1758-8340</issn><issn>1758-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1ks1u1TAQhSMEoqWwZ4UssWET8E-cxCyQSilQqQIJwdqaOOPUl1w7tZNCH4J3xuGW0lZiY1vjc77xjKconjL6krGmecUa2bZCKk6V4FTye8X-GirX2P0b573iUUobSuu6qunDYk9w2Ta1qPaLX19c-k7SHGF21pm8Bk9siMRDCtMZxEs_IIzEQDTOhy28JkBijpQ_Qhz77Fz6S9JBwp5k5xhMiDhkSPbgzxl9WoETzDNGnwj4nhxPaUbny7cQI7lwcUnk3afDbIX-cfHAwpjwydV-UHx7f_z16GN5-vnDydHhaWkkb-dScRCGdqisZYz2DTKUTSOsYRUIpZiiFEFxyyxWXdsJ09nOUiukRGll14uD4mTH7QNs9BTdNheqAzj9JxDioCHOzoyomYGuRqRtr0TFed1Jzq1qJK9py5hhmfVmx5qWbou9QZ-bOd6C3r7x7kwP4UI3XFVVU2XAiytADOcLpllvXTI4juAxLEnzirWMS1GvuZ7fkW7CEnOvV1XG1TR_albRncrEkFJEe_0YRvU6N_ru3GTLs5tFXBv-DkoWlDtBggH_Zf0v8Dea8c1T</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Zhang, Lu-Lu</creator><creator>Huang, Meng-Yao</creator><creator>Fei-Xu</creator><creator>Wang, Ke-Xin</creator><creator>Song, Di</creator><creator>Wang, Ting</creator><creator>Sun, Li-Yue</creator><creator>Shao, Jian-Yong</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><general>SAGE Publishing</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PKEHL</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0171-908X</orcidid></search><sort><creationdate>2020</creationdate><title>Risk stratification for nasopharyngeal carcinoma: a real-world study based on locoregional extension patterns and Epstein-Barr virus DNA load</title><author>Zhang, Lu-Lu ; Huang, Meng-Yao ; Fei-Xu ; Wang, Ke-Xin ; Song, Di ; Wang, Ting ; Sun, Li-Yue ; Shao, Jian-Yong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-92a3c0be9ff110d7e1e5773fc14a3991900ea92f1fe4b8b3cbfbf0f355e5f5bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>Deoxyribonucleic acid</topic><topic>DNA</topic><topic>Epstein-Barr virus</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Nasopharyngeal carcinoma</topic><topic>Original Research</topic><topic>Radiation therapy</topic><topic>Throat cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Lu-Lu</creatorcontrib><creatorcontrib>Huang, Meng-Yao</creatorcontrib><creatorcontrib>Fei-Xu</creatorcontrib><creatorcontrib>Wang, Ke-Xin</creatorcontrib><creatorcontrib>Song, Di</creatorcontrib><creatorcontrib>Wang, Ting</creatorcontrib><creatorcontrib>Sun, Li-Yue</creatorcontrib><creatorcontrib>Shao, Jian-Yong</creatorcontrib><collection>Sage Journals : Open Access Journals [open access]</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Hospital Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Therapeutic advances in medical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Lu-Lu</au><au>Huang, Meng-Yao</au><au>Fei-Xu</au><au>Wang, Ke-Xin</au><au>Song, Di</au><au>Wang, Ting</au><au>Sun, Li-Yue</au><au>Shao, Jian-Yong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk stratification for nasopharyngeal carcinoma: a real-world study based on locoregional extension patterns and Epstein-Barr virus DNA load</atitle><jtitle>Therapeutic advances in medical oncology</jtitle><addtitle>Ther Adv Med Oncol</addtitle><date>2020</date><risdate>2020</risdate><volume>12</volume><spage>1758835920932052</spage><epage>1758835920932052</epage><pages>1758835920932052-1758835920932052</pages><issn>1758-8359</issn><issn>1758-8340</issn><eissn>1758-8359</eissn><abstract><![CDATA[Aim:
The present study aimed to evaluate the combined value of locoregional extension patterns (LEPs) and circulating cell-free Epstein–Barr virus (cf EBV) DNA for risk stratification of locoregionally advanced nasopharyngeal carcinoma (LA-NPC) to better guide therapeutic strategies.
Methods:
A total of 7227 cases of LA-NPC were reviewed retrospectively and classified into six groups according to their LEP (ascending, descending, or mixed type) and pre-treatment cf EBV-DNA load (⩾ versus <4000 copy/ml). Using a supervised statistical clustering approach, patients in the six groups were clustered into low, intermediate, and high-risk clusters. Progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS) were calculated using the Kaplan–Meier method and differences were compared using the log-rank test.
Results:
Survival curves for the low, intermediate, and high-risk clusters were significantly different for all endpoints. The 5-year survival rate for the low, intermediate, and high-risk clusters, respectively, were: PFS (83.5%, 73.2%, 62.6%, p < 0.001), OS (91.0%, 82.7%, 73.2%, p < 0.001), DMFS (92.3%, 83.0%, 73.4%, p < 0.001), and LRRFS (91.0%, 88.0%, 83.3%, p < 0.001). The risk clusters acted as independent prognostic factors for all endpoints. Among the patients in the high-risk cluster, neoadjuvant chemotherapy combined with concurrent chemoradiotherapy (CCRT) significantly improved the patients 5-year PFS (66.4% versus 57.9%, p = 0.014), OS (77.6% versus 68.6%; p < 0.002), and DMFS (76.6% versus 70.6%; p = 0.028) compared with those treated with CCRT.
Conclusion:
Our results could facilitate the development of risk-stratification and risk-adapted therapeutic strategies for patients with LA-NPC.]]></abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>32587634</pmid><doi>10.1177/1758835920932052</doi><orcidid>https://orcid.org/0000-0002-0171-908X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Publicly Available Content Database; Sage Journals : Open Access Journals [open access]; PubMed Central |
| subjects | Chemoradiotherapy Chemotherapy Deoxyribonucleic acid DNA Epstein-Barr virus Medical prognosis Metastases Nasopharyngeal carcinoma Original Research Radiation therapy Throat cancer |
| title | Risk stratification for nasopharyngeal carcinoma: a real-world study based on locoregional extension patterns and Epstein-Barr virus DNA load |
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