Abstract

PurposeThe objective of this study is to assess the prognostic value of ABO blood group in nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).Patients and MethodsWe retrospectively reviewed the data on 1397 patients with non-metastatic, newly diagnosed NPC treated using IMRT. Patient survival between different ABO blood groups were compared using log-rank test. Cox hazards model was adopted to establish independent prognostic factors.ResultsIn our study, the distribution of the A, B, AB and O blood groups was 26.6% (372/1397), 26.2% (366/1397), 5.2% (73/1397) and 42.0% (586/1397), respectively. The cut-off value of pre-treatment Epstein-Barr virus (EBV) DNA based on disease-free survival (DFS) was 1355 copies/ml (area under curve [AUC], 0.649; sensitivity, 0.76; specificity, 0.496) for the whole cohort. Estimated four-year DFS, overall survival (OS), distant metastasis-free survival (DMFS) and locoregional relapse-free survival (LRRFS) rates were 81.7%, 89.2%, 89.4% and 92.3% for blood group A; 82.1%, 89.3%, 89.0% and 92.0% for group B; 83.3%, 88.1%, 86.2% and 95.5% for group AB, 80.9%, 90.7%, 88.4% and 90.2% for group O (P > 0.05 for all rates). Multivariate analysis revealed ABO blood group was not an independent prognostic factor for DFS, OS, DMFS or LRRFS (P > 0.05 for all rates) after adjusting for plasma EBV DNA in either the whole cohort or subgroup analysis by gender.ConclusionsThe prognostic value of ABO blood group may be limited for patients with NPC in the era of IMRT, and no substantial correlation between ABO blood group and plasma EBV DNA was observed.

Highlights

  • Nasopharyngeal carcinoma (NPC), which arises from the nasopharyngeal epithelium, has an extremely unbalanced global distribution [1]

  • The objective of this study is to assess the prognostic value of ABO blood group in nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT)

  • The cut-off value of pre-treatment Epstein-Barr virus (EBV) DNA based on disease-free survival (DFS) was 1355 copies/ml for the whole cohort

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Summary

Introduction

Nasopharyngeal carcinoma (NPC), which arises from the nasopharyngeal epithelium, has an extremely unbalanced global distribution [1]. 86,500 cases of NPC were reported in 2012, with 71% of all new cases in east and Southeast Asia, including southern China [1]. Due to anatomic constraints and its high degree of radiosensitivity, radiotherapy is the main treatment for non-metastatic NPC. The TNM staging system is the most reliable method for guiding clinical treatment and predicting prognosis [2]. The prognosis of early-stage NPC is satisfactory; locoregionally-advanced disease still has a poor prognosis; the 5-year overall survival rates are 87–96% for stage I-II and 67–77% for stage III-IV [3]. Additional novel prognostic factors need to be identified to select patients at high risk and devise individual treatment strategies

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