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Original Article | Open Access

Prognostic significance of a combined and controlled nutritional status score and EBV-DNA in patients with advanced nasopharyngeal carcinoma: a long-term follow-up study

Hui Lu1,2,*, Shanshan Guo1,3,*, Liting Liu1,3,*, Qiuyan Chen1,3, Yujing Liang1,3, Sailan Liu1,3, Xuesong Sun1,3, Qingnan Tang1,3, Xiaoyun Li1,3, Ling Guo1,3, Haoyuan Mo1,3, Linquan Tang1,3 ( ), Haiqiang Mai1,3 ( )
State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
Department of Radiation Oncology, Guangzhou Concord Cancer Center, Guangzhou 510045, China
Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou 510060, China

*These authors contributed equally to this work.

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Abstract

Objective

Several studies have reported that the controlling nutritional status (CONUT) score is a prognostic predictor for survival among patients with different types of cancer. We assessed the prognostic value of changes in the CONUT score during treatment and the ΔCONUT-EBV DNA score in patients with advanced nasopharyngeal carcinoma (NPC).

Methods

We retrospectively analyzed 433 patients with advanced NPC having no evidence of metastasis from January 2007 to June 2011; the patients underwent radical concurrent chemoradiotherapy (CCRT) at Sun Yat-sen University Cancer Center and were grouped based on their ΔCONUT and ΔCONUT-EBV DNA scores. Kaplan-Meier curves were used to compare the patient outcomes according to the cut-off ΔCONUT score and the ΔCONUT-EBV DNA scoring system.

Results

Among all patients, overall survival (OS) was independently predicted by a high ΔCONUT score (P = 0.031) and high EBV DNA (P < 0.001). The ΔCONUT-EBV DNA score [OS area under the curve (AUC) = 0.621; progression free survival (PFS)-AUC = 0.612; distant metastasis-free survival (DMFS)-AUC = 0.622] was more predictive of OS, PFS, and DMFS in patients with advanced NPC than the ΔCONUT score (OS-AUC = 0.547; PFS-AUC = 0.533; DMFS-AUC = 0.522) and pretreatment plasma EBV DNA levels alone (OS-AUC = 0.600; PFS-AUC = 0.591, DMFS-AUC = 0.610). The ΔCONUT-EBV DNA score was significantly correlated with OS, PFS, and DMFS in patients with advanced NPC treated with CCRT.

Conclusions

The ΔCONUT-EBV DNA score may be useful in clinical practice as a convenient biomarker for predicting the outcomes in patients with advanced NPC treated with CCRT.

Keywords

prognosisnasopharyngeal carcinomaControlling nutritional status scoreEpstein-Barr virus deoxyribonucleic acidpredictive factor

Electronic Supplementary Material

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Cancer Biology & Medicine
Volume 19 Issue 4,
April 2022
Pages 551-564
DOI: 10.20892/j.issn.2095-3941.2020.0627
Cite this article:
Lu H, Guo S, Liu L, et al. Prognostic significance of a combined and controlled nutritional status score and EBV-DNA in patients with advanced nasopharyngeal carcinoma: a long-term follow-up study. Cancer Biology & Medicine, 2022, 19(4): 551-564. https://doi.org/10.20892/j.issn.2095-3941.2020.0627

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Received: 08 October 2020
Accepted: 25 December 2020
Published: 01 April 2022
©2022 Cancer Biology & Medicine.

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