Abstract
Undifferentiated (World Health Organization (WHO) 3) type of nasopharyngeal cancer (NPC) is strongly correlated with Epstein-barr (EBV) virus latent infection. Post-treatment viral reactivation is associated with relapsed or recurrence of NPC. Viral activation can be measured indirectly via plasma IgA responses towards EBV proteins such as EBNA1 and VCA-p18. This study aims at determining the prognostic value of IgA/[EBNA1+VCA-p18] on progression free survival and overall survival of NPC patients. NPC patients aged > 18 years, with locally advanced disease receiving concurrent chemoradiation, with weekly cisplatin 40 mg/m2 samples for blood plasma before treatment, 3 months post-treatment, and at 12 months after treatment completion or at the time of disease progression, whichever came first. An established enzyme linked immunosorbent assay (ELISA) method was used for evaluation of IgA/[EBNA1+VCA-p18] level reported as optical density 450 nm (OD450) values. Forty six NPC patients, with male predominance and mostly in productive age were included. Twenty seven patients had disease progression or died during study follow up. Mean of pre-treatment IgA OD450 was higher in patients with progression compared to those still in remission (2.33 ± 1.08 versus 1.66 ± 1.19, p < 0.05). The higher risk serology group (OD450 ≥ 1.4) had shorter time to progression (RR 6.06; p = 0.014; median time to progression is 13.47 month). Overall survival was not influenced by plasma IgA. Pretreatment IgA/[EBNA-1+VCA-p18] may predict early progression for NPC Key words: Nasopharyngeal cancer, prognosis factor, immunological response, IgA/(EBNA1+ VCA-p18).
Highlights
This study aims at determining the prognostic value of IgA/[EBV nuclear antigen 1 (EBNA1)+viral capsid antigen (VCA)-p18] on progression free survival and overall survival of Nasopharyngeal cancer (NPC)
Forty six patients were eligible for this study as shown as Patients were characterized by larger tumor size (60.8%) and extensive neck lymphnodes involvement (56.5%)
Ninety five percent subjects completed their treatment according to protocol
Summary
Nasopharyngeal cancer (NPC) is a common cancer in Southern China, South East Asia and North Africa In Indonesia, NPC is the fourth commonest cancer in men and sixth among women (Adham, 2012). More than 90% of NPC in Indonesia comprised of histology type World Health
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