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Identifying distinct risks of treatment failure in nasopharyngeal carcinoma: Study based on the dynamic changes in peripheral blood lymphocytes, monocytes, N classification, and plasma Epstein-Barr virus DNA
- Source :
- HeadneckREFERENCES. 44(1)
- Publication Year :
- 2021
-
Abstract
- To evaluate the prognostic value of the dynamic change in absolute lymphocyte counts (ALCs) and absolute monocyte counts (AMCs) and identify patients with N stage and plasma Epstein-Barr virus (EBV) DNA levels in nasopharyngeal carcinoma (NPC) who are at risk of treatment failure.A total of 1124 eligible patients with Stage II-IVb NPC treated with concurrent chemoradiotherapy (CCRT) were enrolled. Percentage changes in the ALC (ΔALC%) and AMC (ΔAMC%) were calculated.Patients with high ΔALC% were correlated with poorer 5-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) rates than those with low ΔALC%. Likewise, high ΔAMC% was significantly associated with worse outcome than low ΔAMC% (OS, p = 0.001; PFS, p = 0.001; DMFS, p = 0.034). Multivariate analyses revealed that ΔALC% (p = 0.046), ΔAMC% (p = 0.019), and EBV DNA level (p 0.001) were independent prognostic factors for OS. With respect to PFS, ΔALC% (p = 0.036), ΔAMC% (p = 0.011), N classification (p = 0.016), and EBV DNA level (p 0.001) were also independent prognosticators. Based on the aforementioned independent risk factors (ΔALC% ≥ 83.33%, ΔAMC% ≥ 40.00%, Stage N2-3, EBV DNA ≥ 4000 copies/ml), patients were divided into three different risk groups (low-risk group [with1 risk factor], intermediate risk group [with 1-3 risk factors], and high-risk group [with 4 risk factors]) that correlated with disparate risks of death (p 0.001), disease progression (p 0.001), and distant metastasis (p 0.001).High ΔALC% and ΔAMC% were correlated with poor prognosis in patients with NPC. Risk stratification based on ΔALC%, ΔAMC%, N classification, and plasma EBV DNA levels could provide potential utility for risk-adapted therapeutic strategies for NPC.
- Subjects :
- medicine.medical_specialty
Epstein-Barr Virus Infections
Herpesvirus 4, Human
Multivariate analysis
Lymphocyte
Gastroenterology
Treatment failure
Virus
Monocytes
Internal medicine
medicine
Humans
Lymphocytes
Treatment Failure
Stage (cooking)
Nasopharyngeal Carcinoma
business.industry
Monocyte
Nasopharyngeal Neoplasms
medicine.disease
Prognosis
Peripheral blood
medicine.anatomical_structure
Otorhinolaryngology
Nasopharyngeal carcinoma
DNA, Viral
business
Subjects
Details
- ISSN :
- 10970347
- Volume :
- 44
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- HeadneckREFERENCES
- Accession number :
- edsair.doi.dedup.....1cb533257b2700543fba0d4f454a1fce