Optimal cumulative cisplatin dose in nasopharyngeal carcinoma patients based on plasma Epstein-Barr virus DNA level after induction chemotherapy.

Abstract

PURPOSE:

This study aimed to elucidate the optimal cumulative cisplatin dose (CCD) for concurrent chemoradiotherapy (CCRT) according to the post-induction chemotherapy (IC) plasma Epstein-Barr virus (EBV) DNA level.

RESULTS:

EBV DNA was detected and undetected in 179 and 370 patients, respectively. Of the entire cohort, 73/549 (13.3%) patients received a total CCD ≥ 160 mg/m2 and 476/549 (86.7%) patients, <160 mg/m2. CCD enhancement was not associated with a survival benefit in patients with undetected EBV DNA after IC. However, among patients with post-IC detectable EBV DNA, higher 3-year PFS and locoregional relapse-free survival (LRFS) rates were observed in those who received a CCD ≥ 160 mg/m2. Multivariate analysis also showed CCD was an independent prognostic factor for PFS and LRFS in patients with post-IC detectable EBV DNA.

CONCLUSIONS:

CCD enhancement was not associated with a survival benefit in patients with undetected EBV DNA after IC. However, among patients with post-IC detectable EBV DNA, those receiving ≥160 mg/m2 CCD showed significantly improved 3-year PFS and LRFS.

METHODS:

NPC patients (549) treated with IC and CCRT were included. Prognosis was assessed using a multivariate Cox proportional hazards model. Furthermore, grade 1-4 toxicities were compared between different CCD groups.

• Authors: Sai-Lan Liu, Xue-Song Sun, Li-Ting Liu, Rui Sun, Dong-Hua Luo, Qiu-Yan Chen, Huan-Xin Lin, Li Yuan, Lin-Quan Tang, Ling Guo, Hai-Qiang Mai
• Journal: Aging (Aging (Albany NY)) Vol. 12 Issue 6 Pg. 4931-4944 (03 27 2020) ISSN: 1945-4589 [Electronic] United States
• PMID: 32221045 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (administration & dosage)
• Chemoradiotherapy
• Child
• Cisplatin (administration & dosage)
• Female
• Herpesvirus 4, Human (genetics)
• Humans
• Induction Chemotherapy
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Nasopharyngeal Carcinoma (blood, diagnosis, drug therapy)
• Nasopharyngeal Neoplasms (blood, diagnosis, drug therapy)
• Proportional Hazards Models
• Treatment Outcome
• Young Adult