AUTHOR=Zhu Lisheng , Ouyang Tao , Xiong Ying , Ba Li , Li Qiuting , Qiu Mengjun , Zou Zhenwei , Peng Gang 

TITLE=Prognostic Value of Plasma Epstein-Barr Virus DNA Levels Pre- and Post-Neoadjuvant Chemotherapy in Patients With Nasopharyngeal Carcinoma

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.714433

DOI=10.3389/fonc.2021.714433

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>In this study, we evaluated the prognostic value of the plasma levels of Epstein-Barr virus (EBV) DNA in patients with nasopharyngeal carcinoma (NPC) at different treatment stages.</p></sec><sec><title>Methods</title><p>We retrospectively analyzed the Data of 206 patients with NPC. Pre-neoadjuvant chemotherapy (pre-NACT), post-NACT, post-radiotherapy, and post-treatment plasma EBV DNA levels were used to establish prognostic nomograms. The concordance index (C-index) and calibration curves were used to compare the prognostic accuracy of the nomograms. The results were confirmed in a validation cohort consisting of patients who were tested for EBV DNA levels at all four stages of treatment. The Kaplan-Meier method was used to calculate the progression-free survival (PFS) and overall survival (OS). Survival differences were calculated using the log-rank test.</p></sec><sec><title>Results</title><p>EBV DNA-positive patients had worse 3-year PFS and 5-year OS than EBV DNA-negative patients; this was true for pre-NACT (PFS: 82.7% <italic>vs</italic>. 57.3%, <italic>P</italic> &lt; 0.001; OS: 90.9% <italic>vs</italic>. 68.7%, <italic>P</italic> = 0.08) and post-NACT (PFS: 85.0% <italic>vs</italic>. 50.6%, <italic>P</italic> &lt; 0.001; OS: 91.7% <italic>vs</italic>. 65.7%; <italic>P</italic> = 0.001) EBV DNA levels but not for post-radiotherapy (PFS: 72.2% <italic>vs</italic>. 60.9%, <italic>P</italic> = 0.192; OS: 73.1% <italic>vs</italic>. 77.2%, <italic>P</italic> = 0.472) or post-treatment (PFS: 77.3% <italic>vs</italic>. 59.2%, <italic>P</italic> = 0.063; OS: 77.5% <italic>vs</italic>. 79.7%, <italic>P</italic> = 0.644) levels. Nomograms combining pre-NACT and post-NACT EBV DNA levels had a superior prognostic ability than those of post-radiotherapy and post-treatment EBV DNA levels.</p></sec><sec><title>Conclusion</title><p>Pre-NACT EBV DNA levels combined with post-NACT EBV DNA levels can more reliably predict survival outcomes in patients with NPC.</p></sec>