Epstein–Barr virus DNA change level combined with tumor volume reduction ratio after inductive chemotherapy as a better prognostic predictor in locally advanced nasopharyngeal carcinoma

• Published in: Cancer medicine (Malden, MA) MA), 2023-01, Vol.12 (2), p.1102-1113
• Main Authors: Xiang, Zhong‐zheng, He, Tao, Zeng, Yuan‐yuan, Liu, Fang, Shao, Bian‐fei, Yang, Tian, Ma, Jia‐chun, Wang, Xi‐ran, Yu, Si‐ting, Liu, Lei
• Format: Article
• Language: English
• Subjects: Biopsy; Cancer therapies; Carcinoma - drug therapy; Chemotherapy; DNA viruses; DNA, Viral; Epstein-Barr virus; Epstein-Barr Virus Infections - complications; Epstein–Barr virus DNA change level; Herpesvirus 4, Human - genetics; Humans; inductive chemotherapy; Magnetic resonance imaging; Medical prognosis; Metastases; Metastasis; Nasopharyngeal carcinoma; Nasopharyngeal Carcinoma - pathology; Nasopharyngeal Neoplasms - pathology; Patients; Plasma; Prognosis; Radiation therapy; Remission (Medicine); Retrospective Studies; Risk groups; Survival; Throat cancer; Tomography; Tumor Burden; tumor volume reduction ratio; Tumors; Values
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.4964

Background To explore the prognosis predicting ability of the combined factors, Epstein–Barr virus DNA change level (EBVCL) and tumor volume reduction ratio (TVRR) after inductive chemotherapy (IC), in locally advanced nasopharyngeal carcinoma (LANPC). Methods From 2010 to 2018, 299 LANPC patients were included in this retrospective study. Receiver operating characteristic (ROC) curve analysis was performed to acquire the best critical values. According to the best critical values of EBVCL and TVRR, patients were stratified into low‐ and high‐risk groups. Kaplan–Meier and ROC curve analyses were utilized to verify the prognostic ability of the new predictor (EBVCL+TVRR). The prognostic values among EBVCL+TVRR, EBVCL, TVRR, TNM stage, and the RECIST 1.1 criteria were compared by ROC curve. The primary end points were overall survival (OS), progression‐free survival (PFS), distant metastasis‐free survival (DMFS), and locoregional failure‐free survival (LRFFS). Results ROC curve analyses of TVRR on three‐year survival showed the best critical values of TVRR was 32.72% for OS, 30.21% for PFS and LRFFS, 29.87% for DMFS. The best critical value of EBVCL was 127 copies/ml for OS, and 87.7 copies/ml for PFS, DMFS, and LRFFS. The three‐year OS, PFS, DMFS, and LRFFS for low‐ and high‐risk groups were 97.7% versus 78.3% (hazard ratio [HR] = 0.2398; 95% confidence interval [CI]: 0.1277–0.4502; p