title: Plasma Epstein-Barr Viral Deoxyribonucleic Acid Predicts Worse Outcomes in Pediatric Nonmetastatic Nasopharyngeal Carcinoma Patients: An Observational Study of 89 Cases in an Endemic Area.
abstract: To evaluate the clinical significance of pretreatment levels of plasma Epstein-Barr virus DNA (pEBV DNA) on prognoses in pediatric nasopharyngeal carcinoma (NPC) patients. Eighty-nine patients aged 21 years old or younger with nonmetastatic NPC were evaluated to determine the effect of pEBV DNA levels on progression-free survival (PFS), distant metastasis-free survival (DMFS), and overall survival (OS). Survival probabilities in patient groups that were segregated by clinical stage or pEBV DNA load (low or high) were compared. The median pretreatment concentrations of pEBV DNA were 3440 copies/mL in 35 patients with stage III disease and 14,900 copies/mL in 50 patients with stage IV disease (P = 0.059). The median concentration of pEBV DNA was 34,500 copies/mL in 17 patients with relapse, which was higher than the concentration in 72 patients without relapse, who had a median level of 4985 copies/mL (P = 0.057). Further study showed that pretreatment pEBV DNA load was an independent prognostic indicator in pediatric NPC patients. High pEBV DNA was associated with adverse clinical outcomes, including PFS [3-year PFS rate = 80.5% versus 95.8%, hazard ratio (HR) = 5.00, 95% confidence interval (CI) = 1.00-25.00; P = 0.050], DMFS (3-year DMFS rate = 80.5% versus 95.8%, HR = 5.20, 95% CI = 1.04-26.00; P = 0.045), and OS (3-year OS rate = 82.9% versus 95.8%, HR = 5.41, 95% CI = 1.08-27.22; P = 0.040). Pretreatment pEBV DNA load was an independent prognostic indicator for PFS, DMFS, and OS in pediatric patients with NPC. Prospective studies, however, are needed to validate these results.
authors.affiliation: From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine (TS, L-QT, D-HL, Q-YC, P-JL, D-MM, H-QM, H-YM); Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou (TS, L-QT, D-HL, Q-YC, P-JL, D-MM, H-QM, H-YM); and Department of Oncology, The People's Hospital of Nanhai District, Foshan, The People's Republic of China (TS, W-GG).
authors.forename: Ting
authors.initials: T
authors.lastname: Shen
authors.forename: Lin-Quan
authors.initials: LQ
authors.lastname: Tang
authors.forename: Wei-Guang
authors.initials: WG
authors.lastname: Gu
authors.forename: Dong-Hua
authors.initials: DH
authors.lastname: Luo
authors.forename: Qiu-Yan
authors.initials: QY
authors.lastname: Chen
authors.forename: Pei-Jing
authors.initials: PJ
authors.lastname: Li
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Mai
authors.forename: Hai-Qiang
authors.initials: HQ
authors.lastname: Mai
authors.forename: Hao-Yuan
authors.initials: HY
authors.lastname: Mo
mesh_terms: D000293:Adolescent; D002277:Carcinoma; D002648:Child; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D004854:Herpesvirus 4, Human / Q000378:metabolism*; D006801:Humans; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D004279:DNA, Viral