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- Tran Bao Ngoc, Tran Thi Kim Phuong, Vi Tran Doanh et al (2024) “Changes in plasma EBV DNA in nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy at Thai Nguyen national hospital”, Tạp chí Khoa học&Công nghệ VV88 🎖️ Link Trang Chủ Nhà Cái VV88 Cá Cược Thể Thao, tập 229, số 5, tr. 369-375.

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INFORMATION ON RESEARCH RESULTS

1. General information

- Project title: Research on plasma EBV-DNA concentrations in nasopharyngeal cancer patients before and after radiotherapy treatment at Thai Nguyen Central Hospital.

- Code number: B2022-TNA-29

- Principal investigator: Assoc. Prof Tran Bao Ngoc

- Implementing Institution: Thai Nguyen University

- Duration: from January 2022 to June 2024

2. Objectives

- Determine the plasma EBV-DNA concentrations of nasopharyngeal cancer patients before and after radiotherapy treatment.
- Analyze the relationship between plasma EBV-DNA concentrations and some clinical and paraclinical characteristics.

3. Creativeness and innovativeness

This is one of few domestic studies measuring plasma EBV-DNA load in nasopharyngeal cancer patients, compared with other head and neck cancer groups. Although the sample size is not large enough, the research results meet the two research objectives.

Research results have shown that EBV-DNA is mainly associated with nasopharyngeal cancer and associated less with squamous cell cancer despite both are in the same head and neck anatomical area.

The study also determined decreasing trend in plasma EBV-DNA concentrations in nasopharyngeal cancer patients before and after treatment. In particular, through initial analysis, we determined the relationship between plasma EBV-DNA levels and a number of clinical and paraclinical characteristics in treatment outcomes in cases of nasopharyngeal cancer. Thereby, research results are good recommendations for oncology clinical practice.

4. Research results

4.1. Some general characteristics of research objects

60 nasopharyngeal carcinoma-NPC patients (research group): 68.3% male, male/female ratio is 2.1/1. Average age 52.8 ± 12.4 years (range 28 - 80 years). With 30 other head and neck SCC: 96.7% were men (29 patients). Average age 55.03 ± 8.86 (range 37 - 73 years).

Primary tumors classified as T3 and T2 accounted for the vast majority, with 28 patients (46.7%) and 24 patients (40.0%), respectively. 9 patients did not see regional lymph node metastasis (15%). 80% (48 patients) saw lymph node metastasis at stages N1, N2.

Stage III accounts for the highest proportion with 61.7% (37 patients), followed by 14 cases of stage II (23.3%), the remainder are stage IV.

Histopathological classification: type 3 according to WHO (undifferentiated carcinoma nasopharynx type) with 56 patients, accounting for 93.3%. Types 1 and 2 account for a very low rate.

4.2. Plasma EBV-DNA concentration of study subjects

Up to 93.3% of 30 head and neck SCC patients (control group) were negative for EBV-DNA. The 2 positive cases had low viral loads.

With 60 NPC patients before treatment:

- 23/60 patients with nasopharyngeal cancer (research group) were negative for EBV-DNA, accounting for 38.3%. The positive EBV-DNA rate was 61.7% (37 cases).

- The lowest positive EBV-DNA concentration is 427 copies/ml, the highest is 8960,000 copies/ml. Mean EBV load was 266379.76 copies/ml, median was 2126 copies/ml.

With 60 NPC after treatment:

- There are only 19 EBV-DNA positive patients left (31.7%), the EBV undetected rate is up to 68.3% (41 cases).

- The lowest positive EBV-DNA concentration is 405 copies/ml, the highest is 63,206 copies/ml. The average EBV load is 4850 copies/ml, the median is 486 copies/ml (the difference before and after treatment in EBV-DNA concentration is statistically significant, with p < 0.05).

4.3. Relationship between plasma EBV-DNA concentration and some clinical and paraclinical characteristics

Identification of EBV:

- No differences were found in terms of gender, ethnicity, BMI and residential address. Except for the group of patients under 60 years old, the EBV positive rate was statistically significantly higher than the group of patients over 60 years old (29/41 compared to 8/19), with p < 0.05.

- Tends to stage III and IV; size T3, T4; Cases with EBV-positive regional lymph node metastasis were higher than the corresponding group, but this difference was not statistically significant (p > 0.05).

- There was no relationship between pre-treatment EBV-DNA and some treatment characteristics of the study subjects (Completion of treatment course; Treatment duration; Treatment response).

- There is a tendency for EBV-DNA positivity to be higher in patients without acute blood cell toxicity, but this difference is not statistically significant (p > 0.05).

EBV quantification:

- 4 patients without lymph node metastasis had a significantly higher EBV-DNA viral load with 33 cases having lymph node metastasis (p < 0.05).

- There is a tendency for N0, N1 or T3, T4 or stages III and IV to have higher EBV-DNA concentrations than the corresponding groups (p > 0.05).

- There tends to be a higher average value of EBV-DNA before and after treatment in the group of patients treated for less than 45 days, without a decrease in peripheral blood cells (p > 0.05).   

5. Products

- Tran Bao Ngoc, Tran Thi Kim Phuong, Nguyen Thi Hoa et al (2022), "Epstein Barr virus and nasopharyngeal cancer", Journal of Science & Technology Thai Nguyen University, volume 227, number 10, pp. 282-291.

- Do Duc Huy Hoang, Tran Bao Ngoc, Nguyen Thi Thu Huong (2022), "Early results of accelerated radiotherapy with or without concurrent chemotherapy for nasopharyngeal cancer in Thai Nguyen", Medical Journal Vietnam, volume 519, October, number 2, pp. 8-12.

- Do Duc Huy Hoang (2022), "Early results of accelerated radiotherapy combined with concurrent chemotherapy for nasopharyngeal cancer at Thai Nguyen Oncology Center", Master's thesis, Hanoi Medical University, Scientific guide: Tran Bao Ngoc, Nguyen Thi Thu Huong.

- Hoang Kim Dung (2023), "Response to combined chemotherapy and radiotherapy and some related factors in patients with nasopharyngeal cancer at Thai Nguyen Central Hospital", Thesis outline for Resident Doctor, University of Medicine and Pharmacy - Thai Nguyen University, scientific guide: Tran Bao Ngoc.

- Tran Bao Ngoc, Tran Thi Kim Phuong, Vi Tran Doanh et al (2024) “Changes in plasma EBV DNA in nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy at Thai Nguyen national hospital”, Journal of Science & Technology Thai Nguyen University, volume 229, number 5, pp. 369-375.

- Ngoc Bao Tran, Phuong Kim Thi Tran, Dung Kim Hoang, Doanh Tran Vi, Hoa Thi Nguyen, Thuan Duc Lao (2024) “Relationship between EBV and Some Other Factors with Concurrent Chemo-Radiotherapy Response in Nasopharyngeal Cancer Patients at Vietnam”, The Journal of Molecular Diagnostics (passed round 1 review).

6. Transfer alternatives, application institutions, impact and benefits of research results

Oncology facilities will make EBV viral load testing of nasopharyngeal cancer patients a routine and require health insurance to pay for it. After simultaneous implementation with a large sample size and great significance in disease prognosis, it will be the basis for recommending screening and early detection of lung cancer in high-risk communities.

Health training institutions will have scientific data to update teaching content for learners with the Cancer module.