An integrated model of the gross tumor volume of cervical lymph nodes and pretreatment plasma Epstein–Barr virus DNA predicts survival of nasopharyngeal carcinoma in the intensity-modulated radiotherapy era: a big-data intelligence platform-based analysis. (September 2019)

• Record Type: Journal Article
• Authors: Li, Jun-Yan; Huang, Cheng-Long; Luo, Wei-Jie; Zhang, Yuan; Tang, Ling-Long; Peng, Hao; Sun, Ying; Chen, Yu-Pei; Ma, Jun
• Is Part Of: Therapeutic advances in medical oncology. Volume 11(2019)
• Publication Date: 2019-09
• Subjects: distant metastasis-free survival -- gross tumor volume of lymph nodes -- nasopharyngeal carcinoma -- overall survival -- pretreatment plasma Epstein–Barr virus DNA -- prognostic model; Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.994005
• DOI: 10.1177/1758835919877729
• Languages: English
• ISSNs: 1758-8340

Abstract

Background: Few studies have evaluated the prognostic value of the integrated model consisting of gross tumor volume of lymph nodes (GTVnd) and pretreatment plasma Epstein–Barr virus DNA (pre-EBV DNA) in nasopharyngeal carcinoma (NPC) patients. Methods: A well-established big-data intelligence platform with 10, 126 NPC patients was used for a retrospective review. A total of 1500 cases with cervical nodal metastases but without distant metastases were randomly assigned to a training ( n = 503) or test condition ( n = 997) for analyses. The cut-off point for the GTVnd derived from the receiver operating characteristic (ROC) curve was combined with the published cut-off point for pre-EBV DNA to develop an integrated model by which patients were classified into four groups. Results: Both GTVnd and pre-EBV DNA were independent prognostic factors. Regardless of whether patients received induction chemotherapy (IC), the 5-year distant metastasis-free survival (DMFS) (69.5%) and overall survival (OS) (68.4%) were significantly worse in those with both a GTVnd >20 ml and pre-EBV DNA >2000 copies/ml (all p- values < 0.001). In patients with IC, all others had better 5-year DMFS and OS; in patients without IC, those with either a GTVnd >20 ml or pre-EBV DNA >2000 copies/ml had the medium 5-year DMFS and OS, while patients with neither of them had the best. Conclusions: The integrated GTVnd and pre-EBV DNA model not only predicted DMFS and OS in NPC patients effectively, but was an indicator of timely adjustment of therapeutic strategies for NPC patients, especially those completing IC.