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Conference Paper: 5-Year Results of the Prognostic Roles of Serial Post-Intensity-Modulated Radiation Therapy Undetectable Plasma EBV DNA for Non-Metastatic Nasopharyngeal Carcinoma
Title | 5-Year Results of the Prognostic Roles of Serial Post-Intensity-Modulated Radiation Therapy Undetectable Plasma EBV DNA for Non-Metastatic Nasopharyngeal Carcinoma |
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Authors | |
Issue Date | 2018 |
Publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp |
Citation | 60th Annual Meeting of the Amercian Society for Radiation Oncology (ASTRO), San Antonio, TA, 21-24 October 2018. In International Journal of Radiation Oncology - Biology - Physics, 2018, v. 102 n. 3, suppl., p. S126-S127, abstract no. 261 How to Cite? |
Abstract | Purpose/Objective(s):
We previously demonstrated that post-IMRT 8th week and 6th month undetectable plasma EBV DNA were significant prognostic factors of 3-year survival endpoints for non-metastatic NPC. We now presented our 5-year results. (NCT02476669).
Materials/Methods:
Patients with previously untreated non-metastatic NPC confirmed by PET-CT and MRI scans were prospectively recruited from 2010 to 2016. They all had plasma EBV DNA measured at baseline, and then 8 weeks and 6 months following IMRT with/without concurrent +/- adjunct chemotherapy. They were staged and treated based on the 7th edition TNM of AJCC/UICC Staging Classification. Covariates including age, sex, ACE-27, pretreatment LDH and plasma EBV DNA were analyzed by Cox regression for prognostic factors of progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS).
Results:
A total of 518 patients were prospectively recruited. 71 (13.7%) patients received IMRT alone, while 90 (17.4%) and 357 (68.9%) received concurrent chemoradiation alone and concurrent chemoradiation followed by adjunct chemotherapy respectively. The median pretreatment plasma EBV DNA titers was 494 copies/ml (range 0-175000 copies/ml). After a median follow-up of 5.2 years, 38 (7.3%) and 21 (4.1%) patients still had detectable titers at 8 weeks and 6 months following IMRT. 5-year PFS, CSS and OS in the whole study population were 77.1%, 90.4% and 84.4% respectively. Patients with post-IMRT 8th week and 6th month undetectable plasma EBV DNA titers enjoyed longer 5-year survival endpoints (PFS 79.1% vs. 40.9%; CSS 93.8% vs. 58.8%; OS 85.7% vs. 55.3%; all p<0.001), which were also lengthened for those with post-IMRT 6th month undetectable titers (PFS 78.7% vs. 19.0%; CSS 93.4% vs. 39.7%; OS 85.5% vs. 37.5%; all p<0.001), compared to those who still had detectable titers at the corresponding time points. They are also the only prognostic factors of these endpoints in multivariable analyses (all p<0.001).
Conclusion:
Post-IMRT 8th week and 6th month undetectable plasma EBV DNA remained significant prognostic factors after 5 years of follow-up. Additional therapy may have to be considered for those who had persistently detectable plasma EBV DNA after IMRT. |
Persistent Identifier | http://hdl.handle.net/10722/265103 |
ISSN | 2023 Impact Factor: 6.4 2023 SCImago Journal Rankings: 1.992 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lee, VHF | - |
dc.contributor.author | Kwong, DLW | - |
dc.contributor.author | Leung, TW | - |
dc.contributor.author | Choi, CW | - |
dc.contributor.author | O'Sullivan, B | - |
dc.contributor.author | Lai, V | - |
dc.contributor.author | Tong, CC | - |
dc.contributor.author | Lam, KO | - |
dc.contributor.author | Ng, CY | - |
dc.contributor.author | Chan, SY | - |
dc.contributor.author | Ho, PYP | - |
dc.contributor.author | Chan, WLW | - |
dc.contributor.author | Leung, DK | - |
dc.contributor.author | Chan, SK | - |
dc.contributor.author | Tsang, KC | - |
dc.contributor.author | Khong, PL | - |
dc.contributor.author | Luk, MY | - |
dc.contributor.author | Lee, WMA | - |
dc.date.accessioned | 2018-11-20T02:00:12Z | - |
dc.date.available | 2018-11-20T02:00:12Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | 60th Annual Meeting of the Amercian Society for Radiation Oncology (ASTRO), San Antonio, TA, 21-24 October 2018. In International Journal of Radiation Oncology - Biology - Physics, 2018, v. 102 n. 3, suppl., p. S126-S127, abstract no. 261 | - |
dc.identifier.issn | 0360-3016 | - |
dc.identifier.uri | http://hdl.handle.net/10722/265103 | - |
dc.description.abstract | Purpose/Objective(s): We previously demonstrated that post-IMRT 8th week and 6th month undetectable plasma EBV DNA were significant prognostic factors of 3-year survival endpoints for non-metastatic NPC. We now presented our 5-year results. (NCT02476669). Materials/Methods: Patients with previously untreated non-metastatic NPC confirmed by PET-CT and MRI scans were prospectively recruited from 2010 to 2016. They all had plasma EBV DNA measured at baseline, and then 8 weeks and 6 months following IMRT with/without concurrent +/- adjunct chemotherapy. They were staged and treated based on the 7th edition TNM of AJCC/UICC Staging Classification. Covariates including age, sex, ACE-27, pretreatment LDH and plasma EBV DNA were analyzed by Cox regression for prognostic factors of progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). Results: A total of 518 patients were prospectively recruited. 71 (13.7%) patients received IMRT alone, while 90 (17.4%) and 357 (68.9%) received concurrent chemoradiation alone and concurrent chemoradiation followed by adjunct chemotherapy respectively. The median pretreatment plasma EBV DNA titers was 494 copies/ml (range 0-175000 copies/ml). After a median follow-up of 5.2 years, 38 (7.3%) and 21 (4.1%) patients still had detectable titers at 8 weeks and 6 months following IMRT. 5-year PFS, CSS and OS in the whole study population were 77.1%, 90.4% and 84.4% respectively. Patients with post-IMRT 8th week and 6th month undetectable plasma EBV DNA titers enjoyed longer 5-year survival endpoints (PFS 79.1% vs. 40.9%; CSS 93.8% vs. 58.8%; OS 85.7% vs. 55.3%; all p<0.001), which were also lengthened for those with post-IMRT 6th month undetectable titers (PFS 78.7% vs. 19.0%; CSS 93.4% vs. 39.7%; OS 85.5% vs. 37.5%; all p<0.001), compared to those who still had detectable titers at the corresponding time points. They are also the only prognostic factors of these endpoints in multivariable analyses (all p<0.001). Conclusion: Post-IMRT 8th week and 6th month undetectable plasma EBV DNA remained significant prognostic factors after 5 years of follow-up. Additional therapy may have to be considered for those who had persistently detectable plasma EBV DNA after IMRT. | - |
dc.language | eng | - |
dc.publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp | - |
dc.relation.ispartof | International Journal of Radiation Oncology - Biology - Physics | - |
dc.title | 5-Year Results of the Prognostic Roles of Serial Post-Intensity-Modulated Radiation Therapy Undetectable Plasma EBV DNA for Non-Metastatic Nasopharyngeal Carcinoma | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Lee, VHF: vhflee@hku.hk | - |
dc.identifier.email | Kwong, DLW: dlwkwong@hku.hk | - |
dc.identifier.email | Leung, TW: ltw920@hkucc.hku.hk | - |
dc.identifier.email | Choi, CW: hcchoi@hku.hk | - |
dc.identifier.email | Lai, V: laiv@hku.hk | - |
dc.identifier.email | Tong, CC: tccz01@hku.hk | - |
dc.identifier.email | Lam, KO: lamkaon@hku.hk | - |
dc.identifier.email | Ng, CY: ngchoryi@hku.hk | - |
dc.identifier.email | Ho, PYP: pattyho@hku.hk | - |
dc.identifier.email | Chan, WLW: winglok@hku.hk | - |
dc.identifier.email | Khong, PL: plkhong@hku.hk | - |
dc.identifier.email | Luk, MY: myluk@hkucc.hku.hk | - |
dc.identifier.email | Lee, WMA: awmlee@hkucc.hku.hk | - |
dc.identifier.authority | Lee, VHF=rp00264 | - |
dc.identifier.authority | Kwong, DLW=rp00414 | - |
dc.identifier.authority | Lai, V=rp01516 | - |
dc.identifier.authority | Lam, KO=rp01501 | - |
dc.identifier.authority | Chan, WLW=rp02541 | - |
dc.identifier.authority | Khong, PL=rp00467 | - |
dc.identifier.authority | Lee, WMA=rp02056 | - |
dc.description.nature | abstract | - |
dc.identifier.doi | 10.1016/j.ijrobp.2018.06.315 | - |
dc.identifier.hkuros | 296156 | - |
dc.identifier.volume | 102 | - |
dc.identifier.issue | 3, suppl. | - |
dc.identifier.spage | S126, abstract no. 261 | - |
dc.identifier.epage | S127, abstract no. 261 | - |
dc.identifier.isi | WOS:000447811602510 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0360-3016 | - |