Annals of nasopharynx cancer最新文献

{"title":"Prognostic value of Epstein-Barr virus biomarkers for nasopharyngeal carcinoma staging and post-treatment surveillance","authors":"Jacob A. Miller, B. Pinsky, Q. Le","doi":"10.21037/anpc-21-5","DOIUrl":"https://doi.org/10.21037/anpc-21-5","url":null,"abstract":": The relationship between Epstein-Barr virus (EBV) infection and endemic nasopharyngeal carcinoma (NPC) has facilitated more than 40 years of biomarker-inspired translational research. Serologic and nucleic acid EBV biomarkers span the spectrum of this disease from population-level early detection, pre-treatment prognostication, response-adapted therapy, and long-term surveillance. Plasma EBV DNA remains the cornerstone of biomarker prognostication and surveillance for NPC, and there is increasing high-quality evidence that it merits inclusion in future staging systems. Recently-completed and ongoing biomarker-adapted clinical trials will determine whether biomarker-adapted management will become the standard of care. The HKNPCSG-0502 randomized trial demonstrated that post-treatment EBV DNA is prognostic but not predictive for response to adjuvant chemotherapy (AC), while the ongoing NRG-HN001 randomized trial may ultimately support the omission of AC in most patients. The next generation of biomarker-informed clinical trials may integrate early response to induction chemotherapy and/or immunotherapy. In this review, we discuss the clinical role and prognostic performance of EBV-based biomarkers for pre-treatment staging and post-treatment surveillance. In particular, we synthesize the available evidence which suggests that biomarker-informed staging systems might improve upon anatomic staging, but highlight the challenges in inter-laboratory reproducibility inherent to diagnostic assays without international standardization. Thereafter, we review a breadth of evidence which supports that undetectable post-treatment EBV biomarkers are highly specific for long-term cure. Finally, we contextualize emerging biomarkers that may further improve prognostication. Although these novel biomarkers have yet to supersede plasma EBV DNA in clinical performance, they may complement EBV DNA and identify the subset of patients at highest risk for clinical relapse. 12","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48795929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epstein-Barr virus-based nasopharyngeal carcinoma population screening","authors":"Xia Yu, Honglin Chen, M. Ji","doi":"10.21037/anpc-21-6","DOIUrl":"https://doi.org/10.21037/anpc-21-6","url":null,"abstract":"Nasopharyngeal carcinoma (NPC) is characterized by its distinct geographical distribution and has a high incidence in southern China and Southeast Asia. Early diagnosis and treatment are the best strategies for individuals identified to have a high risk of NPC. The identification of high-risk populations and the use of appropriate screening methods are key factors when screening for NPC. Despite the discovery of the close association of Epstein-Barr virus (EBV) with NPC, the exact role of the virus in the development of NPC has not been completely elucidated. EBV serological antibody testing is of great significance while screening for NPC, and plasma EBV-DNA has been used for population screening. The screening also includes clinical examination (lymphatic palpation and indirect examination of the nasopharynx using a mirror) and obtaining the family history of patients with NPC. The main secondary screening methods include nasopharyngeal fiberscopy. Another approach to diagnose NPC includes cytological examination of the nasopharyngeal brush exfoliates. Evidence suggests that serological screening for NPC can increase the rate of early diagnosis and significantly improve the 5-year survival rate of the affected population. However, the NPC serological screening protocol has some shortcomings. For example, the positive predictive value needs to be improved. Further research into NPC should be focused on methods that will accurately identify high-risk individuals and optimize screening. Here, we have reviewed the latest progress in EBV-based NPC population screening.","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41359230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of circulating tumor cells for real-time serial monitoring of nasopharyngeal carcinoma patients","authors":"J. Ko","doi":"10.21037/anpc-21-7","DOIUrl":"https://doi.org/10.21037/anpc-21-7","url":null,"abstract":"","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41767875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the CARE guideline as reporting standard in the Annals of Nasopharynx Cancer","authors":"","doi":"10.21037/anpc.2019.11.01","DOIUrl":"https://doi.org/10.21037/anpc.2019.11.01","url":null,"abstract":"","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/anpc.2019.11.01","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45932705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy dose escalation in the primary treatment of nasopharyngeal carcinoma: a systematic review and meta-analysis","authors":"L. B. A. Co, R. A. Agas, J. Jacinto, K. Yu, M. A. Mejia, W. Bacorro","doi":"10.21037/ANPC.2019.04.01","DOIUrl":"https://doi.org/10.21037/ANPC.2019.04.01","url":null,"abstract":"Background: Dose escalation with radiotherapy (RT) in nasopharyngeal carcinoma (NPC) remains underutilized despite significant advances in methods of radiation delivery. RT boost during primary treatment has been shown to improve local control rates, which could have an impact on survival. We summarize the currently available evidence for dose escalation in the primary treatment of NPC. \u0000 Methods: Databases were systematically searched for eligible studies from the year 2000. Included studies utilized RT dose escalation (BED >70 Gy) in the form of brachytherapy, external beam RT or stereotactic RT boost after external beam RT for primary treatment of NPC. Local recurrence-free survival (LRFS), overall survival (OS), toxicities and other relevant factors for the chosen studies were then pooled and analyzed. \u0000 Results: Two randomized trials and 7 retrospective cohort studies with a total of 2,145 patients were included in the final analysis. Nine hundred and eighty-eight patients received dose escalation, mainly in the form of brachytherapy (90%). Patients were mostly male, from China/Southeast Asia, had T1-T2 disease (80%), underwent RT via conventional techniques (87%). Less than half received concurrent chemotherapy. Three-year LRFS (RR 1.04; 95% CI: 0.85–1.28, P=0.71) and OS were not significantly improved with dose escalation. However, the subset of patients pooled from the retrospective studies who did not receive concurrent chemotherapy showed significant a 5-year locoregional failure-free survival (RR 1.05; 95% CI: 1.02–1.09, P=0.005) benefit. Toxicities were not significantly increased with dose escalation. \u0000 Conclusions: RT dose escalation in the primary treatment of NPC does not lead to an increase in LRFS, OS, progression free-survival and disease free-survival. However, there seems to be a LRFS benefit with dose escalation using brachytherapy in patients with T1-T2 disease and in patients who did not receive concurrent chemotherapy. Dose escalation with brachytherapy is likewise not significantly associated with any increase in the rate of complications. Data for the efficacy and toxicity of EBRT and SRT boost is currently still lacking.","PeriodicalId":93728,"journal":{"name":"Annals of nasopharynx cancer","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/ANPC.2019.04.01","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48310600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}