Akademik Veri Yönetim Sistemi
DEGRO 2026 32. Kongress der Deutschen Gesellschaft für Radioonkologie, Leipzig, Almanya, 25 - 27 Haziran 2026, ss.1, (Özet Bildiri)
Background: Plasma Epstein–Barr virus
DNA (EBV-DNA) is a validated biomarker of tumor burden in nasopharyngeal
carcinoma (NPC), but access to qPCR testing may be limited in
resource-constrained and non-endemic settings. We evaluated correlations
between pretreatment EBV-DNA and routinely available hematological and
biochemical indices in non-metastatic NPC.
Methods: A total of 107 patients
diagnosed with NPC who received radiotherapy with or without chemotherapy
between 2010 and 2024 and had available pretreatment EBV-DNA, complete blood
count, and biochemistry data were retrospectively analyzed. Associations between
pretreatment EBV-DNA and 35 hematological, biochemical, and composite
inflammatory–nutritional indices were assessed using Spearman’s rank
correlation. Missing data were handled using pairwise deletion (available-case
analysis). Overall survival (OS), progression-free survival (PFS), locoregional
recurrence-free rate (LRRFR), and distant recurrence-free rate (DRFR) were
estimated using the Kaplan–Meier method, and prognostic factors were evaluated
using univariate and multivariate Cox regression. Statistical significance was
set at p < 0.05.
Results: Eighty-three patients (77.6%) were
male; median age was 50 (12-76), and 88 (82.2%) had stage III-IV disease.
Median follow-up was 68.0 months. Five-year OS, PFS, LRRFR, and DRFR rates were
84.8%, 77.7%, 85.3%, and 88.2%, respectively. Parameters correlated with
EBV-DNA were: LDH (r=0.433; p=0.001), CRP (r=0.280; p=0.032), LDH×CRP index
(r=0.364; p=0.021), LDH/lymphocyte ratio (r=0.435; p=0.001), LDH/albumin ratio
(r=0.469; p=0.001), CRP/albumin ratio (r=0.319; p=0.024), CALLY index
(r=-0.289; p=0.028), and lymphocyte/CRP ratio (r=-0.291; p=0.025). In
univariate analysis, age >50, >10 pack-year smoking,
prevertebral muscle invasion, high primary tumor SUVmax, and high total GTV
were associated with both PFS and OS. Additionally, level IV-Vb lymph node
metastasis and EBV-DNA >3,500 copies/mL were significant for PFS;
high involved lymph node SUVmax and EBV-DNA >10,000 copies/mL were
significant for OS. In multivariate analysis, only age >50 remained
significant for PFS; only high total GTV remained significant for OS.
Conclusions: Pretreatment EBV-DNA
showed moderate correlations with LDH- and CRP-based composite indices in
non-metastatic NPC from a non-endemic region. LAR demonstrated the strongest
association with EBV-DNA, suggesting it may help approximate tumor burden when
EBV-DNA testing is not readily available. Prospective multicenter validation
and formal assessment of predictive performance are warranted.