Can Epstein–Barr virus-deoxyribonucleic acid load after induction chemotherapy combined with American Joint Committee on Cancer stage determine the chemotherapy intensity of locally advanced nasopharyngeal carcinoma?

Can Epstein–Barr virus-deoxyribonucleic acid load after induction chemotherapy combined with American Joint Committee on Cancer stage determine the chemotherapy intensity of locally advanced nasopharyngeal carcinoma? | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Can Epstein–Barr virus-deoxyribonucleic acid load after induction chemotherapy combined with American Joint Committee on Cancer stage determine the chemotherapy intensity of locally advanced nasopharyngeal carcinoma? Qun Zhang, Yan Wang, Cheng-Tao Wang, Guo-Ping Shen, YunYing Yang, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6224853/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Induction chemotherapy (IC) with docetaxel, cisplatin, and fluorouracil (TPF), combined with concurrent chemoradiotherapy (CCRT), has been shown to improve survival in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) . Our previous study demonstrated that adjusting the number of IC cylces based on TNM stage and Epstein-Barr virus DNA (EBV-DNA) load after IC did not compromise efficacy while reducing toxicity. However, due to the small sample size, there is a need for further confirmation of the long-term outcomes . Methods: This retrospective analysis evaluated the clinical data and survival outcomes of patients with stage III–IVaLA-NPC treated with TPF IC followed by CCRT. Patients in the conventional treatment group received three standard cycles of TPF IC an d CCRT, while those in the experimental group had IC cycles determined by EBV-DNA clearance . If EBV-DNA was undetectable after a certain IC course, subsequent IC was stopped, and CCRT commenced. Propensity score matching (PSM) was performed at a ratio of 1:4 to balance baseline characteristics. Survival outcomes between the two groups were compared. Results: A total of 730 patients were included , and 481 patients were successfully matched into 106 pairs . The median followed-up duration was 116months. The 5-year survival outcomes before and after matching, respectively, were as follows: distant metastasis-free survival (89 .3%vs.87.6%, P=0.52/ 87.9% vs . 87.6%, P=0.886), local recurrence-free survival (90 .3%vs. 81.9%, P=0.015/88 .8% vs . 81.9%, P=0.069),progression-free survival (81 . 1%vs . 68.7%, P=0.003/78.5%vs .68.7%, P=0.033), and overall survival (85 .9% vs . 85.3%, P=0.795 / 84.4%vs.85.3%, P=0.870) . Conclusions: This study addresses an important clinical question about the use of EBV-DNA as a marker for optimizing IC in LA-NPC patients, and presents promising findings that could enhance patient outcomes.The results provides a valuable foundation for future research but requires further confirmation through well-designed prospective trials. Trial registration : This is a retrospective study without registration for prospective clinical trial. chemotherapy intensity Epstein–Barr virus DNA induction chemotherapy locoregionally advanced nasopharyngeal carcinoma Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6224853","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":442057820,"identity":"5fda29f9-bb9e-4a41-93a8-2b9e8f347beb","order_by":0,"name":"Qun Zhang","email":"","orcid":"","institution":"First Affiliated Hospital of SunYat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Qun","middleName":"","lastName":"Zhang","suffix":""},{"id":442057821,"identity":"81ace6a5-86c7-4f32-a6b8-618982590e15","order_by":1,"name":"Yan Wang","email":"","orcid":"","institution":"First Affiliated Hospital of SunYat-sen 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carcinoma?\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"chemotherapy intensity, Epstein–Barr virus DNA, induction chemotherapy, locoregionally advanced, nasopharyngeal carcinoma","lastPublishedDoi":"10.21203/rs.3.rs-6224853/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6224853/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eInduction chemotherapy (IC) with docetaxel, cisplatin, and fluorouracil (TPF), combined with concurrent chemoradiotherapy (CCRT), has been shown to improve survival in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) . Our previous study demonstrated that adjusting the number of IC cylces based on TNM stage and Epstein-Barr virus DNA (EBV-DNA) load after IC did not compromise efficacy while reducing toxicity. However, due to the small sample size, there is a need for further confirmation of the long-term outcomes .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis retrospective analysis evaluated the clinical data and survival outcomes of patients with stage III–IVaLA-NPC treated with TPF IC followed by CCRT. Patients in the conventional treatment group received three standard cycles of TPF IC an d CCRT, while those in the experimental group had IC cycles determined by EBV-DNA clearance . If EBV-DNA was undetectable after a certain IC course, subsequent IC was stopped, and CCRT commenced. Propensity score matching (PSM) was performed at a ratio of 1:4 to balance baseline characteristics. Survival outcomes between the two groups were compared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA total of 730 patients were included , and 481 patients were successfully matched into 106 pairs . The median followed-up duration was 116months. The 5-year survival outcomes before and after matching, respectively, were as follows: distant metastasis-free\u003c/p\u003e\n\u003cp\u003esurvival (89 .3%vs.87.6%, P=0.52/ 87.9% vs . 87.6%, P=0.886), local recurrence-free survival\u003c/p\u003e\n\u003cp\u003e(90 .3%vs. 81.9%, P=0.015/88 .8% vs . 81.9%, P=0.069),progression-free survival (81 . 1%vs . 68.7%, P=0.003/78.5%vs .68.7%, P=0.033), and overall survival (85 .9% vs . 85.3%, P=0.795 / 84.4%vs.85.3%, P=0.870) .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e This study addresses an important clinical question about the use of EBV-DNA as a marker for optimizing IC in LA-NPC patients, and presents promising findings that could enhance patient outcomes.The results provides a valuable foundation for future research but requires further confirmation through well-designed prospective trials.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration : \u003c/strong\u003eThis is a retrospective study without registration for prospective clinical trial.\u003c/p\u003e","manuscriptTitle":"Can Epstein–Barr virus-deoxyribonucleic acid load after induction chemotherapy combined with American Joint Committee on Cancer stage determine the chemotherapy intensity of locally advanced nasopharyngeal carcinoma?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-23 12:26:48","doi":"10.21203/rs.3.rs-6224853/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"18c0809c-41d1-4720-9d90-2d65c9f6956c","owner":[],"postedDate":"April 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-13T15:38:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-23 12:26:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6224853","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6224853","identity":"rs-6224853","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}