CNG（协同鼻咽癌组）分期：调强放疗时代鼻咽癌预后分层改善及与eb病毒DNA的关系

IF 5.3 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-07-19 DOI:10.1016/j.radonc.2025.111051

Shuohan Zheng , Ya Liu , Zheng He , Shuiqing He , Zilu Huang , Wei Luo , Fei Han , Yalan Tao , Chunyan Chen , Puyun Ouyang , Lei Chen , Ying Huang , Guanqun Zhou , Wenfei Li , Qing Liu , Chen Chen , Yunfei Xia

{"title":"CNG（协同鼻咽癌组）分期：调强放疗时代鼻咽癌预后分层改善及与eb病毒DNA的关系","authors":"Shuohan Zheng , Ya Liu , Zheng He , Shuiqing He , Zilu Huang , Wei Luo , Fei Han , Yalan Tao , Chunyan Chen , Puyun Ouyang , Lei Chen , Ying Huang , Guanqun Zhou , Wenfei Li , Qing Liu , Chen Chen , Yunfei Xia","doi":"10.1016/j.radonc.2025.111051","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Current 8th AJCC stage is less effective in differentiating survival for nasopharyngeal carcinoma (NPC) in the intensity-modulated radiotherapy era. This study aims to evaluate the performance of CNG (Collaborative Nasopharyngeal Carcinoma Group) stage, a clinical downstaging of NPC based on the 7th AJCC stage, in predicting prognosis compared with the AJCC stage.</div></div><div><h3>Methods</h3><div>In this prospective observational study (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier: NCT03529279), 1930 patients were restaged based on the 7th stage: CNG Stage I: Stage I, II, and III-nonT3N2; CNG Stage II: III-T3N2, IVA, and IVB; CNG Stage III: IVC. Kaplan-Meier method and the log-rank test were performed.</div></div><div><h3>Results</h3><div>The 5-year overall survival (OS) of patients with CNG Stage I, II, and III was 97.0 %, 91.4 %, and 72.1 %, and survival curves of different stage groups were well-separated (all p < 0.001). The OS curves for 7th and 8th Stage I, II, and III almost overlapped. In patients with pre-treatment plasma EBV DNA > 0 and ≥ 1000 copies/ml, overall and inter-group OS differences were observed in CNG stage, while not shown in 7th and 8th stages. Among CNG Stage I, II, and III, the proportion of patients with EBV DNA = 0 was gradually decreasing (30.9 % vs 10.8 % vs 3.4 %), while the proportion of EBV DNA ≥ 1000 was gradually increasing (33.3 % vs 60.0 % vs 84.8 %, p < 0.001).</div></div><div><h3>Conclusions</h3><div>The CNG staging system presents a more accurate segregation of survival rates than the 7th and 8th editions, and it is well aligned with EBV DNA. Further studies of the staging system are warranted.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Article 111051"},"PeriodicalIF":5.3000,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"CNG (Collaborative Nasopharyngeal Carcinoma Group) stage: Improved prognostic stratification of nasopharyngeal carcinoma and association with Epstein-Barr virus DNA in the intensity-modulated radiation therapy era\",\"authors\":\"Shuohan Zheng , Ya Liu , Zheng He , Shuiqing He , Zilu Huang , Wei Luo , Fei Han , Yalan Tao , Chunyan Chen , Puyun Ouyang , Lei Chen , Ying Huang , Guanqun Zhou , Wenfei Li , Qing Liu , Chen Chen , Yunfei Xia\",\"doi\":\"10.1016/j.radonc.2025.111051\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Current 8th AJCC stage is less effective in differentiating survival for nasopharyngeal carcinoma (NPC) in the intensity-modulated radiotherapy era. This study aims to evaluate the performance of CNG (Collaborative Nasopharyngeal Carcinoma Group) stage, a clinical downstaging of NPC based on the 7th AJCC stage, in predicting prognosis compared with the AJCC stage.</div></div><div><h3>Methods</h3><div>In this prospective observational study (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier: NCT03529279), 1930 patients were restaged based on the 7th stage: CNG Stage I: Stage I, II, and III-nonT3N2; CNG Stage II: III-T3N2, IVA, and IVB; CNG Stage III: IVC. Kaplan-Meier method and the log-rank test were performed.</div></div><div><h3>Results</h3><div>The 5-year overall survival (OS) of patients with CNG Stage I, II, and III was 97.0 %, 91.4 %, and 72.1 %, and survival curves of different stage groups were well-separated (all p < 0.001). The OS curves for 7th and 8th Stage I, II, and III almost overlapped. In patients with pre-treatment plasma EBV DNA > 0 and ≥ 1000 copies/ml, overall and inter-group OS differences were observed in CNG stage, while not shown in 7th and 8th stages. Among CNG Stage I, II, and III, the proportion of patients with EBV DNA = 0 was gradually decreasing (30.9 % vs 10.8 % vs 3.4 %), while the proportion of EBV DNA ≥ 1000 was gradually increasing (33.3 % vs 60.0 % vs 84.8 %, p < 0.001).</div></div><div><h3>Conclusions</h3><div>The CNG staging system presents a more accurate segregation of survival rates than the 7th and 8th editions, and it is well aligned with EBV DNA. Further studies of the staging system are warranted.</div></div>\",\"PeriodicalId\":21041,\"journal\":{\"name\":\"Radiotherapy and Oncology\",\"volume\":\"210 \",\"pages\":\"Article 111051\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-07-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiotherapy and Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0167814025045554\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiotherapy and Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167814025045554","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：在调强放疗时代，目前AJCC第8期对鼻咽癌（NPC）的生存鉴别效果较差。本研究旨在评价在AJCC第7期基础上的鼻咽癌临床降期CNG （Collaborative nashar咽癌组）分期与AJCC分期比较，对鼻咽癌预后的预测作用。方法：在这项前瞻性观察性研究（ClinicalTrials.gov Identifier: NCT03529279）中，1930例患者根据第7期进行再分期：CNG I期：I期，II期和iii期-非t3n2；CNG II期：III-T3N2， IVA和IVB；CNG第三阶段：IVC。采用Kaplan-Meier法和log-rank检验。结果：CNG I、II、III期患者的5年总生存率（OS）分别为97.0 %、91.4 %和72.1 %，不同分期组的生存曲线分离较好（p均为 0和 ≥ 1000 copies/ml）， CNG期总体和组间OS有差异，7、8期无差异。在CNG阶段I, II, III,患者EBV DNA = 0的比例逐渐下降(30.9 vs 10.8  % % 3.4 vs %),而EBV DNA的比例 ≥1000年 逐渐增加(33.3 vs 60.0  % % 84.8 vs %,p 结论:CNG分期系统提出了一种更精确的种族隔离的存活率比7日和8日版,并与EBV DNA结合起来。分级系统的进一步研究是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

CNG (Collaborative Nasopharyngeal Carcinoma Group) stage: Improved prognostic stratification of nasopharyngeal carcinoma and association with Epstein-Barr virus DNA in the intensity-modulated radiation therapy era

Background

Current 8th AJCC stage is less effective in differentiating survival for nasopharyngeal carcinoma (NPC) in the intensity-modulated radiotherapy era. This study aims to evaluate the performance of CNG (Collaborative Nasopharyngeal Carcinoma Group) stage, a clinical downstaging of NPC based on the 7th AJCC stage, in predicting prognosis compared with the AJCC stage.

Methods

In this prospective observational study (ClinicalTrials.gov Identifier: NCT03529279), 1930 patients were restaged based on the 7th stage: CNG Stage I: Stage I, II, and III-nonT3N2; CNG Stage II: III-T3N2, IVA, and IVB; CNG Stage III: IVC. Kaplan-Meier method and the log-rank test were performed.

Results

The 5-year overall survival (OS) of patients with CNG Stage I, II, and III was 97.0 %, 91.4 %, and 72.1 %, and survival curves of different stage groups were well-separated (all p < 0.001). The OS curves for 7th and 8th Stage I, II, and III almost overlapped. In patients with pre-treatment plasma EBV DNA > 0 and ≥ 1000 copies/ml, overall and inter-group OS differences were observed in CNG stage, while not shown in 7th and 8th stages. Among CNG Stage I, II, and III, the proportion of patients with EBV DNA = 0 was gradually decreasing (30.9 % vs 10.8 % vs 3.4 %), while the proportion of EBV DNA ≥ 1000 was gradually increasing (33.3 % vs 60.0 % vs 84.8 %, p < 0.001).

Conclusions

The CNG staging system presents a more accurate segregation of survival rates than the 7th and 8th editions, and it is well aligned with EBV DNA. Further studies of the staging system are warranted.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.