A systematic review and recommendations on the use of plasma EBV DNA for nasopharyngeal carcinoma

鼻咽癌 医学 爱泼斯坦-巴尔病毒 肿瘤科 恶性肿瘤 重症监护医学 生物标志物 内科学 病毒 免疫学 放射治疗 生物 遗传学
作者
Anne W.M. Lee,Victor Lee,Wai Tong Ng,Primož Strojan,Nabil F. Saba,Alessandra Rinaldo,Stefan M. Willems,Juan P. Rodrigo,Arlene A. Forastiere,Alfio Ferlito
出处
期刊:European Journal of Cancer [Elsevier BV]
卷期号:153: 109-122 被引量:73
标识
DOI:10.1016/j.ejca.2021.05.022
摘要

Nasopharyngeal carcinoma (NPC) is an endemic malignancy in Southeast Asia, particularly Southern China. The classical non-keratinising cell type is almost unanimously associated with latent Epstein-Barr virus (EBV) infection. Circulating plasma EBV DNA can be a useful biomarker in various clinical aspects, but comprehensive recommendations and international guidelines are still lacking. We conducted a systematic review of all original articles on the clinical application of plasma EBV DNA for NPC; we further evaluated its strengths and limitations for consideration as standard recommendations.The search terms 'nasopharyngeal OR nasopharynx', and 'plasma EBV DNA OR cell-free EBV OR cfEBV' were used to identify full-length articles published up to December 2020 in the English literature. Three authors independently reviewed the article titles, removed duplicates and reviewed the remaining articles for eligibility.A total of 81 articles met the eligibility criteria. Based on the levels of evidence and grades of recommendation assessed, it is worth considering the inclusion of plasma EBV DNA in screening, pre-treatment work-up for enhancing prognostication and tailoring of treatment strategy, monitoring during radical treatment, post-treatment surveillance for early detection of relapse, and monitoring during salvage treatment for recurrent or metastatic NPC. One major limitation is the methodology of measurement requiring harmonisation for consistent comparability.The current comprehensive review supports the inclusion of plasma EBV DNA in international guidelines in the clinical aspects listed, but methodological issues must be resolved before global application.
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