This work was supported by the Hong Kong UGC Area of Excellence (AoE) scheme.
Head and Neck
The role of plasma Epstein-Barr virus DNA in the management of recurrent nasopharyngeal carcinoma
Article first published online: 29 MAY 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 1, pages 126–130, January 2014
How to Cite
Chan, J. Y. W. and Wong, S. T.-S. (2014), The role of plasma Epstein-Barr virus DNA in the management of recurrent nasopharyngeal carcinoma. The Laryngoscope, 124: 126–130. doi: 10.1002/lary.24193
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 20 DEC 2013
- Article first published online: 29 MAY 2013
- Accepted manuscript online: 20 MAY 2013 02:59AM EST
- Manuscript Revised: 18 APR 2013
- Manuscript Accepted: 18 APR 2013
- Plasma Epstein-Barr virus DNA;
- recurrent nasopharyngeal carcinoma;
- local recurrence;
- systemic metastasis
To study the role of plasma Epstein-Barr virus (EBV) DNA in patients with recurrent nasopharyngeal carcinoma (NPC) after previous chemoradiation.
Sixty patients with recurrent NPC were recruited, and their plasma EBV DNA was checked preoperatively, 1 week postoperatively, and 6 months thereafter. In a pilot group of 30 patients, further testing was performed at 60 minutes after tumor resection. The plasma EBV DNA level was correlated with tumor T classification, resection margin status, and subsequent relapse.
The mean preoperative plasma EBV DNA reflected the tumor load (T1: 48 copies/mL, T2: 316 copies/mL, T3: 890 copies/mL, P = .03). It was significantly higher in patients with positive margins at the time of surgery (722 vs. 126 copies/mL, P = .02) and in those with subsequent systemic metastasis (668 vs. 92 copies/mL, P = .01). However, it failed to predict local recurrence after surgery. Postoperative plasma EBV DNA was undetectable in all patients with positive resection margins. Serial measurements were able to identify 87.5% of local recurrences and 100% of distance metastases.
In patients with recurrent NPC requiring salvage nasopharyngectomy, preoperative plasma EBV DNA identifies patients at high-risk of subsequent distant failure after surgery. Serial measurements of plasma EBV DNA after surgery, especially for those with high preoperative levels, is crucial to allow early detection of local of distant failure. Laryngoscope, 124:126–130, 2014