TABLE 4.
Associations of survival with pre‐treatment EBV status detected using various techniques
| Pre‐treatment EBV status | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference | No. of NPC patients | EBV detection modality | Target | Cut‐off value | Detectable | Undetectable | P value | Difference ¶ | Treatment | Follow‐up (months) | Survival endpoint |
| Vo et al. (2016) [39] | 46 | EBV DNA | BamHI‐W | – | ‐ ‡ | ‐ ‡ | 0.03 | ‐ ‡ |
Stage I‐II: RT Stage III‐IV: CTRT |
18.7 | OS |
| EBNA‐1 | ‐ ‡ | ‐ ‡ | 0.02 | ‐ ‡ | OS | OS | |||||
| CTC | Canonical | ‐ ‡ | ‐ ‡ | 0.66 | ‐ ‡ | OS | |||||
| Potential | ‐ ‡ | ‐ ‡ | 0.13 | ‐ ‡ | OS | ||||||
| Sengar et al. (2016) [68] | 76 | EBV DNA | EBNA‐1 | 3.8 copies/mL | 42.4 mo nths (mean) | 69.1 mo nths (mean) | 0.023 | 26.7 mo nths | CT and CTRT | 38.8 | OS |
| BamH1W‐76 | 7.3 copies/mL | 42.4 months (mean) | 69.1 months (mean) | 0.023 | 26.7 months | OS | |||||
| Lin et al. (2004) [85] | 99 | EBV DNA | BamHI‐W | 1500 copies/mL | 83.4% | 100% | <0.001 | 16.6% | CTRT | 30 | 2‐year OS rate |
| 66.4% | 88.8% | 0.02 | 22.4% | 2‐year RFS rate | |||||||
| Prayongrat et al. (2017) [86] † | 204 | EBV DNA | BamHI‐W | 600 copies/mL | 66.6% | 86.6% | 0.005 | 20.0% | IMRT | 35.1 | 3‐year PFS rate |
| 64.9% | 74.5% | 0.005 | 9.6% | 5‐year PFS rate | |||||||
| 80.8% | 94% | 0.028 | 13.2% | 3‐year OS rate | |||||||
| 67.0% | 82.6% | 0.028 | 15.6% | 5‐year OS rate | |||||||
| Peng et al. (2016) [87] | 584 | EBV DNA | BamHI‐W | 2010 copies/mL | 78.1% | 93.6% | <0.001 | 15.5% | IMRT | 38.2 (4.6‐58.6) | 3‐year DFS rate |
| 92.3% | 98.9% | <0.001 | 6.6% | 3‐year OS rate | |||||||
| 90.9% | 96.9% | 0.004 | 6.0% | 3‐year LRRFS rate | |||||||
| 85.5% | 96.6% | <.001 | 11.1% | 3‐year DMFS rate | |||||||
| Twu et al. (2007) [88] | 114 s | EBV DNA | BamHI‐W | 1500 copies/mL | 60.3% | 93.1% | <0.0001 | 32.8% | CTRT | 46 | 4‐year OS rate |
| 54.4% | 77.9% | 0.0009 | 23.5% | 4‐year RFS rate | |||||||
| 43.1% | 17.5% | 0.0027 | 25.6% | Relapse | |||||||
| Serology | VCA IgA | 1:80 | 29.9% | 27.9% | 0.754 | 2.0% | Relapse | ||||
| VCA IgG | 1:2560 | 31.8% | 27.8% | 0.697 | 4.0% | Relapse | |||||
| Ling et al. (2009) [89] | 317 | Serology | IgA EA/VCA | ≥1:160 | 43% | 65% | 0.01 | 22.0% | RT | 110 | 5‐year Survival rate |
| Chan et al. (2002) [95] | 170 | EBV DNA | BamHI‐W | 4000 copies/mL | ‐ ‡ | ‐ ‡ | 0.023 | ‐ ‡ | RT ± CT | 29 | 1‐year PFS rate |
| ‐ ‡ | ‐ ‡ | <0.001 | ‐ ‡ | OS | |||||||
| ‐ ‡ | ‐ ‡ | 0.005 | ‐ ‡ | Time to local recurrence | |||||||
| ‐ ‡ | ‐ ‡ | <0.001 | ‐ ‡ | Time to distant recurrence | |||||||
| Chen et al. (2018) [111] | 68 | CTC | Affinity‐based | 3 | 34.1% | 11.5% | 0.047 | 22.6% | IMRT+/‐ CT | 12 | 1Y disease progression |
Interpreting the table using Prayongrat et al. (2017) [86] as an example: using a cut‐off value of 600 copies/mL, 66.6% of those with detectable EBV DNA levels survived 3 years, whereas 86.6% of those with undetectable levels survived 3 years.
Difference in survival endpoint for those with detectable versus undetectable pre‐treatment values for the respective EBV detection modalities.
A dash (‐) indicates that the value could not be obtained from the cited paper.
Abbreviations: CT, chemotherapy; CTC, circulating tumour cells.; DFS, disease‐free survival; DMFS, distant metastasis‐free survival; EA, early antigen; EBV, epstein‐barr virus; Ig, Immunoglobulin; IMRT, intensity modulated radiotherapy; LRRFS, loco‐regional relapse‐free survival; OS, overall survival, PFS, progression free survival; RFS, relapse free survival; RT, radiotherapy; VCA, viral capsid antigen.