- Considering both pretreatment DNA levels of Epstein-Barr virus (EBV) and cervical node necrosis (CNN) can improve risk stratification in patients with nasopharyngeal carcinoma (NPC) undergoing intensity-modulated radiotherapy (IMRT).
Why this matters
- Better prognostic tools can aid in patient treatment stratification.
- 5-year OS was 92.6%, 5-year PFS was 85.0%, 5-year locoregional relapse-free survival was 95.4%, and 5-year distant metastasis-free survival (DMFS) was 90.1%.
- High EBV DNA (>4000 copies/mL) was associated with poor OS (HR, 2.166; P=.005), PFS (HR, 1.619; P=.015), and DMFS (HR, 1.795; P=.018) in multivariate analysis.
- CNN was associated with poor OS (HR, 1.927; P=.016), PFS (HR, 1.492; P=.014), and DMFS (HR, 1.661; P=.016) in multivariate analysis.
- EBV DNA level and CNN were correlated (correlation coefficient, 0.324; P<.001>
- Combined EBV DNA level and CNN status were independent prognostic factors for OS (P<.001 pfs and dmfs>
- 607 patients with nonmetastatic NPC treated with IMRT±chemotherapy were analyzed for associations among CNN, EBV DNA, and outcomes.
- Funding: National Key R&D Program of China; National Natural Science Foundation of China; Sun Yat-Sen University, Guangdong Province; Sci‐Tech Project Foundation, Guangzhou City; National Science & Technology Pillar Program; Cultivation Foundation; others.
- Assessment of CNN by MRI, not biopsy.