Combination of smoking and Epstein-Barr virus DNA is a predictor of poor prognosis for nasopharyngeal carcinoma: a long-term follow-up retrospective study

BMC Cancer

Research Article

Ping Ouyang¹  Chao Yang²  Zonghua Li³  Feipeng Zhao⁴  Shuting Wu⁵  Zilu Chen⁵  Linchong Cui⁵  Xiaofei Yuan⁵  Huiru Feng⁵  Yue Yuan⁵  Juan Lu⁵  Danfan Lin⁵  Xiaohong Peng⁵  Wanxia Li⁶  Junzheng Li⁷  Jing Chen⁸ 

[1] Department of Health Management, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Otolaryngology, 942 Hospital of the Chinese People’s Liberation Army, 750001, Yinchuan, Ningxia, China;Department of Otolaryngology-Head and Neck Surgery, Chengdu Second People’s Hospital, 610000, Chengdu, Sichuan, China;Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Health Management, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Otolaryngology-Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, 510220, Guangzhou, Guangdong, China;School of Traditional Chinese Medicine, Southern Medical University, 510515, Guangzhou, Guangdong, China;

关键词: Smoking;    EBV DNA;    Prognosis;    Combination;    Nasopharyngeal carcinoma;   

DOI  :  10.1186/s12885-022-10297-w

 received in 2022-07-13, accepted in 2022-11-08,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThis retrospective study was performed to determine the prognostic potential of smoking and its combination with pre-treatment plasma Epstein-Barr virus (EBV) DNA levels in patients with nasopharyngeal carcinoma (NPC).MethodsMedical records of 1080 non-metastatic NPC patients who received intensity-modulated radiotherapy were reviewed. Male patients were categorized as never and ever smokers, and the smoking amount, duration, and cumulative consumption were used to evaluate dose-dependent effects. Survival outcomes were assessed using Kaplan-Meier survival analysis and the multivariate Cox regression analysis. Propensity score matching (PSM) was constructed.ResultsThe 5-year overall survival (OS) was worse for ever smokers than never smokers, and significantly decreased with the increase of smoking amount, duration, and cumulative consumption. Compared with never smokers, the multivariate-adjusted hazard ratio (HR) of death was higher in ever smokers (HR = 1.361, P = 0.049), those smoked ≥20 cigarettes/day (HR = 1.473, P = 0.017), those smoked for ≥30 years (HR = 1.523, P = 0.023), and those cumulative smoked for ≥30 pack-years (HR = 1.649, P = 0.005). The poor prognostic effects of smoking was also confirmed in the PSM analysis. The combination of cumulative smoking consumption and pre-treatment EBV DNA levels was proven to be an independent poor prognostic factor for male NPC, and the risk of death, progression, and distant metastases gradually increased with both factors (P < 0.001).ConclusionsCombination of smoking and pre-treatment EBV DNA levels as a predictor of poor prognosis could further improve the risk stratification and prognostication for NPC.

【 授权许可】

CC BY   
© The Author(s) 2022

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