Original Research

Treatment outcomes of Epstein-Barr virus-associated nasopharyngeal carcinoma

Santhuri Viranna, Hue-Tsi Wu, Sameera Dalvie
South African Journal of Oncology | Vol 8 | a279 | DOI: https://doi.org/10.4102/sajo.v8i0.279 | © 2024 Santhuri Viranna, Hue-Tsi Wu, Sameera Dalvie | This work is licensed under CC Attribution 4.0
Submitted: 13 June 2023 | Published: 29 January 2024

About the author(s)

Santhuri Viranna, Department of Radiation Oncology, Faculty of Health Sciences, University of Cape Town, South Africa; and Department of Radiation Oncology, Faculty of Radiation Medicine, Groote Schuur Hospital, Cape Town, South Africa
Hue-Tsi Wu, Department of Histopathology, Pathcare, Cape Town, South Africa
Sameera Dalvie, Department of Radiation Oncology, Faculty of Health Sciences, University of Cape Town, South Africa; and Department of Radiation Oncology, Faculty of Radiation Medicine, Groote Schuur Hospital, Cape Town, South Africa

Abstract

Background: Data on treatment outcomes of Epstein-Barr virus (EBV) associated nasopharyngeal carcinoma (NPC) largely comes from endemic regions. There is limited literature regarding the epidemiology and treatment outcomes of EBV-associated NPC in South Africa.

Aim: The aim of the study was to compare overall survival (OS) of EBV positive and EBV negative NPC patients.

Setting: Groote Schuur Hospital, South Africa.

Methods: Data were collected on all patients with histologically confirmed NPC over an 11-year period, including prevalence of EBV, OS, disease-free survival (DFS), loco-regional control (LRC), and impact of treatment interruptions on OS.

Results: There were 53 patients in total. Non-keratinising carcinoma was the primary histological subtype (86.8%). The majority of patients had EBV positive NPC (47.2%). The 2- and 5-year OS of EBV positive patients treated with curative intent were significantly higher than EBV negative patients, 84.0% versus 34.0% and 45.0% versus 17.0%, respectively (hazard ratio [HR] 0.25, 95% confidence interval [CI]: 0.10–0.63, p = 0.002). Two-year DFS was 55.0% versus 43.0% (HR: 0.59, 95% CI: 0.18–1.98, p = 0.38) and 2-year LRC were 76.2% versus 46.2% (HR: 0.40, 95% CI: 0.12–1.36, p = 0.13) for EBV positive and EBV negative patients respectively.

Conclusion: Treatment of EBV-associated NPC is associated with superior OS compared to EBV negative tumours.

Contribution: Epstein-Barr virus was found to be a significant prognostic factor associated with superior OS compared to EBV negative NPC. These findings correlate with literature from endemic and non-endemic regions.


Keywords

nasopharyngeal carcinoma; Epstein-Barr virus (EBV); prevalence; 3D-CRT; survival outcomes; prognostic factors; treatment interruptions.

Sustainable Development Goal

Goal 16: Peace, justice and strong institutions

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