Role of plasma EBV DNA levels in predicting recurrence of nasopharyngeal carcinoma in a western population

Daris Ferrari, Carla Codecà, Cecilia Bertuzzi, Francesca Broggio, Francesca Crepaldi, Andrea Luciani, Irene Floriani, Mohssen Ansarin, Fausto Chiesa, Daniela Alterio, Paolo Foa

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Abstract

Background: Loco-regionally advanced nasopharyngeal carcinomas can be cured by the combination of chemotherapy and radiotherapy. In Eastern countries, plasma levels of viral Epstein-Barr deoxyribonucleic acid (DNA) are accurate in predicting recurrence, but few data are available in Western populations. The aim of this prospective study was to evaluate the relationship between viral Epstein-Barr DNA copy numbers in plasma and the response rate, progression-free survival and overall survival in a cohort of Western patients with stage IIb-IVb nasopharyngeal cancer. Methods: We evaluated plasma samples from 36 consecutive patients treated with induction chemotherapy followed by chemoradiation. EBV copy numbers were determined after DNA extraction using real-time quantitative polymerase chain reaction. Survival curves were estimated using the Kaplan-Meier method. Results: Circulating Epstein-Barr virus DNA levels were measured before treatment, at the end of concomitant chemo- and radiotherapy, and during the follow-up period. Pre-treatment levels significantly correlated with the initial stage and probability of relapse. Their increase was 100% specific and 71.3% sensitive in detecting locoregional or metastatic recurrence (an overall accuracy of 94.4%). Three-year progression-free and overall survival were respectively 78.2% and 97.1%. Conclusions: The results of this study confirm that patients from a Western country affected by loco-regionally advanced nasopharyngeal carcinoma have high plasma Epstein-Barr virus DNA levels at diagnosis. The monitoring of plasma levels is sensitive and highly specific in detecting disease recurrence and metastases.

Original languageEnglish
Article number208
JournalBMC Cancer
Volume12
DOIs
Publication statusPublished - 2012

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Keywords

  • Chemoradiotherapy
  • Epstein-Barr virus
  • Induction chemotherapy
  • Nasopharyngeal carcinoma
  • Plasma EBV DNA copy numbers

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

Cite this

Ferrari, D., Codecà, C., Bertuzzi, C., Broggio, F., Crepaldi, F., Luciani, A., Floriani, I., Ansarin, M., Chiesa, F., Alterio, D., & Foa, P. (2012). Role of plasma EBV DNA levels in predicting recurrence of nasopharyngeal carcinoma in a western population. BMC Cancer, 12, [208]. https://doi.org/10.1186/1471-2407-12-208