Highlights
- •Plasma Epstein–Barr virus DNA has been the most reliable and accurate marker in nasopharyngeal carcinoma management.
- •We provide evidence-based recommendations on its use in various clinical settings.
- •We support its inclusion in international guidelines in the aspects listed.
- •Limitations and methodological issues must be resolved before its global application.
Abstract
Introduction
Nasopharyngeal carcinoma (NPC) is an endemic malignancy in Southeast Asia, particularly
Southern China. The classical non-keratinising cell type is almost unanimously associated
with latent Epstein–Barr virus (EBV) infection. Circulating plasma EBV DNA can be
a useful biomarker in various clinical aspects, but comprehensive recommendations
and international guidelines are still lacking. We conducted a systematic review of
all original articles on the clinical application of plasma EBV DNA for NPC; we further
evaluated its strengths and limitations for consideration as standard recommendations.
Methods
The search terms ‘nasopharyngeal OR nasopharynx’, and ‘plasma EBV DNA OR cell-free
EBV OR cfEBV’ were used to identify full-length articles published up to December
2020 in the English literature. Three authors independently reviewed the article titles,
removed duplicates and reviewed the remaining articles for eligibility.
Results
A total of 81 articles met the eligibility criteria. Based on the levels of evidence
and grades of recommendation assessed, it is worth considering the inclusion of plasma
EBV DNA in screening, pre-treatment work-up for enhancing prognostication and tailoring
of treatment strategy, monitoring during radical treatment, post-treatment surveillance
for early detection of relapse, and monitoring during salvage treatment for recurrent
or metastatic NPC. One major limitation is the methodology of measurement requiring
harmonisation for consistent comparability.
Conclusions
The current comprehensive review supports the inclusion of plasma EBV DNA in international
guidelines in the clinical aspects listed, but methodological issues must be resolved
before global application.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of CancerAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Management of nasopharyngeal carcinoma: current practice and future perspective.J Clin Oncol. 2015; 33: 3356-3364
- Expression of Epstein-Barr virus genes and of lymphocyte activation molecules in undifferentiated nasopharyngeal carcinomas.Am J Pathol. 1992; 140: 879-887
- Abundant expression of EBER1 small nuclear RNA in nasopharyngeal carcinoma. A morphologically distinctive target for detection of Epstein-Barr virus in formalin-fixed paraffin embedded carcinoma specimens.Am J Pathol. 1991; 138: 1461-1469
- Epstein-Barr virus carriage by nasopharyngeal carcinoma in situ.Int J Canc. 1993; 53: 746-750
- A review of human carcinogens–Part B: biological agents.Lancet Oncol. 2009; 10: 321-322
- Genome diversity of Epstein-Barr virus from multiple tumor types and normal infection.J Virol. 2015; 89: 5222-5237
- Quantitative analysis of cell-free Epstein-Barr virus DNA in plasma of patients with nasopharyngeal carcinoma.Canc Res. 1999; 59: 1188-1191
- Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma.N Engl J Med. 2004; 350: 2461-2470
- Different clinical significance of pre- and post-treatment plasma Epstein-Barr virus DNA load in nasopharyngeal carcinoma treated with radiotherapy.Clin Oncol. 2011; 23: 128-133
- Plasma Epstein-Barr viral deoxyribonucleic acid quantitation complements tumor-node-metastasis staging prognostication in nasopharyngeal carcinoma.J Clin Oncol. 2006; 24: 5414-5418
- Plasma Epstein-Barr viral DNA load at midpoint of radiotherapy course predicts outcome in advanced-stage nasopharyngeal carcinoma.Ann Oncol. 2014; 25: 1204-1208
- Role of plasma EBV DNA levels in predicting recurrence of nasopharyngeal carcinoma in a Western population.BMC Canc. 2012; 12: 208
- Kinetics of plasma Epstein-Barr virus DNA during radiation therapy for nasopharyngeal carcinoma.Canc Res. 2000; 60: 2351-2355
- Plasma Epstein-Barr virus DNA and residual disease after radiotherapy for undifferentiated nasopharyngeal carcinoma.J Natl Canc Inst. 2002; 94: 1614-1619
- Plasma Epstein-Barr virus DNA concentration and clearance rate as novel prognostic factors for metastatic nasopharyngeal carcinoma.Head Neck. 2012; 34: 1064-1070
- Plasma EBV DNA clearance rate as a novel prognostic marker for metastatic/recurrent nasopharyngeal carcinoma.Clin Canc Res. 2010; 16: 1016-1024
- Plasma Epstein-Barr virus DNA level strongly predicts survival in metastatic/recurrent nasopharyngeal carcinoma treated with palliative chemotherapy.Cancer. 2011; 117: 3750-3757
- Rapid clearance of plasma Epstein-Barr virus DNA after surgical treatment of nasopharyngeal carcinoma.Clin Canc Res. 2003; 9: 3254-3259
- Quantitative analysis of plasma cell-free Epstein-Barr virus DNA in nasopharyngeal carcinoma after salvage nasopharyngectomy: a prospective study.Head Neck. 2004; 26: 878-883
- Prognostic impact of plasma Epstein-Barr virus DNA in patients with nasopharyngeal carcinoma treated using intensity-modulated radiation therapy.Sci Rep. 2016; 6: 22000
- Epstein-Barr viral DNA in serum of patients with nasopharyngeal carcinoma.Clin Canc Res. 1998; 4: 665-669
- Epstein-Barr virus DNA in serum/plasma as a tumor marker for nasopharyngeal cancer.Canc Res. 2000; 6: 1046-1051
- Molecular characterization of circulating EBV DNA in the plasma of nasopharyngeal carcinoma and lymphoma patients.Canc Res. 2003; 63: 2028-2032
- Comparison of plasma Epstein–Barr virus (EBV) DNA levels and serum EBV immunoglobulin A/virus capsid antigen antibody titers in patients with nasopharyngeal carcinoma.Cancer. 2004; 100: 1162-1170
- Improved accuracy of detection of nasopharyngeal carcinoma by combined application of circulating Epstein-Barr virus DNA and anti-Epstein-Barr viral capsid antigen IgA antibody.Clin Chem. 2004; 50: 339-345
- Comparison of Epstein-Barr virus DNA level in plasma, peripheral blood cell and tumor tissue in nasopharyngeal carcinoma.Anticancer Res. 2004; 24: 4059-4066
- Comparison of the prognostic impact of serum anti-EBV antibody and plasma EBV DNA assays in nasopharyngeal carcinoma.Int J Radiat Oncol Biol Phys. 2007; 67: 130-137
- Plasma Epstein-Barr virus immunoglobulin A and DNA for nasopharyngeal carcinoma screening in the United States.Otolaryngol Head Neck Surg. 2007; 136: 992-997
- Combined determination of Epstein-Barr virus-related antibodies and antigens for diagnosis of nasopharyngeal carcinoma.Ai Zheng. 2009; 28: 76-78
- Clinical significance of plasma Epstein-Barr virus DNA loads in a large cohort of Malaysian patients with nasopharyngeal carcinoma.J Clin Virol. 2012; 55: 34-39
- Detection of cell free Epstein-Barr virus DNA in sera from patients with nasopharyngeal carcinoma.Cancer. 2002; 94: 723-729
- EBV specific antibody-based and DNA-based assays in serologic diagnosis of nasopharyngeal carcinoma.Int J Canc. 2003; 105: 706-709
- Diagnostic value of serum EBV-DNA quantification and antibody to viral capsid antigen in nasopharyngeal carcinoma patients.Canc Sci. 2004; 95: 508-513
- Laboratory markers of tumor burden in nasopharyngeal carcinoma: a comparison of viral load and serologic tests for Epstein-Barr virus.Int J Canc. 2004; 112: 1036-1041
- Serum EBV DNA as a biomarker in primary nasopharyngeal carcinoma of Indian origin.Jpn J Clin Oncol. 2004; 34: 307-311
- Distribution of Epstein-Barr viral load in serum of individuals from nasopharyngeal carcinoma high-risk families in Taiwan.Int J Canc. 2006; 118: 780-784
- Analysis of Epstein-Barr viral DNA load, EBV-LMP2 specific cytotoxic T-lymphocytes and levels of CD4+CD25+ T cells in patients with nasopharyngeal carcinomas positive for IgA antibody to EBV viral capsid antigen.Chin Med J (Engl). 2009; 122: 1173-1178
- Complementary determination of Epstein-Barr virus DNA load and serum markers for nasopharyngeal carcinoma screening and early detection in individuals at risk in Tunisia.Eur Arch Otorhinolaryngol. 2012; 269: 1005-1011
- Quantitative and temporal correlation between circulating cell-free Epstein-Barr virus DNA and tumor recurrence in nasopharyngeal carcinoma.Canc Res. 1999; 59: 5452-5455
- The appropriate use of circulating EBV-DNA in nasopharyngeal carcinoma: comprehensive clinical practice guidelines evaluation.Oral Oncol. 2021; 114: 105128https://doi.org/10.1016/j.oraloncology.2020.105128
- Head and Neck cancers version 1.2021 – November 9, 2020.National Comprehensive Cancer Network®, 2020https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdfDate accessed: December 30, 2020
- Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up.Ann Oncol. 2020; S0923–7534: 43210-43217
- Molecular prognostication of nasopharyngeal carcinoma by quantitative analysis of circulating Epstein-Barr virus DNA.Canc Res. 2000; 60: 6878-6881
- Pretherapy quantitative measurement of circulating Epstein-Barr virus DNA is predictive of posttherapy distant failure in patients with early-stage nasopharyngeal carcinoma of undifferentiated type.Cancer. 2003; 98: 288-291
- Long-term prognostic effects of plasma Epstein-Barr Virus DNA by minor groove binder-probe real-time quantitative PCR on nasopharyngeal carcinoma patients receiving concurrent chemoradiotherapy.Int J Radiat Oncol Biol Phys. 2007; 68: 1342-1348
- Plasma Epstein-Barr virus DNA screening followed by 18F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting posttreatment failures of nasopharyngeal carcinoma.Cancer. 2011; 117: 4452-4459
- Prognostic significance of 18F-FDG PET parameters and plasma Epstein-Barr virus DNA load in patients with nasopharyngeal carcinoma.J Nucl Med. 2012; 53: 21-28
- Is pre-treatment Epstein-Barr virus DNA still associated with 6-year survival outcomes in locoregionally advanced nasopharyngeal carcinoma?.J Canc. 2017; 8: 976-982
- Early detection of nasopharyngeal carcinoma by plasma Epstein-Barr virus DNA analysis in a surveillance program.Cancer. 2013; 119: 1838-1844
- Long-term survival analysis of nasopharyngeal carcinoma by plasma Epstein-Barr virus DNA levels.Cancer. 2013; 119: 963-970
- Metronomic adjuvant chemotherapy improves treatment outcome in nasopharyngeal carcinoma patients with postradiation persistently detectable plasma Epstein-Barr virus deoxyribonucleic acid.Int J Radiat Oncol Biol Phys. 2014; 89: 21-29
- Evaluation of plasma Epstein-Barr virus DNA load to distinguish nasopharyngeal carcinoma patients from healthy high-risk populations in Southern China.Cancer. 2014; 120: 1353-1360
- Pre-treatment Epstein-Barr virus DNA load and cumulative cisplatin dose intensity affect long-term outcome of nasopharyngeal carcinoma treated with concurrent chemotherapy: experience of an institute in an endemic area.Oncol Res Treat. 2014; 37: 88-95
- The clinical utility of plasma Epstein-Barr virus DNA assays in nasopharyngeal carcinoma: the dawn of a new era? A systematic review and meta-analysis of 7836 cases.Medicine (Baltim). 2015; 94: e845
- The prognostic value of plasma Epstein-Barr viral DNA and tumor response to neoadjuvant chemotherapy in advanced-stage nasopharyngeal carcinoma.Int J Radiat Oncol Biol Phys. 2015; 93: 862-869
- Different prognostic values of plasma Epstein-Barr virus DNA and maximal standardized uptake value of 18F-FDG PET/CT for nasopharyngeal carcinoma patients with recurrence.PLoS One. 2015; 10e0122756
- Impact of plasma Epstein-Barr virus-DNA and tumor volume on prognosis of locally advanced nasopharyngeal carcinoma.BioMed Res Int. 2015; 2015: 617949
- Plasma Epstein-Barr viral deoxyribonucleic acid predicts worse outcomes in pediatric nonmetastatic nasopharyngeal carcinoma patients: an observational study of 89 cases in an endemic area.Medicine (Baltim). 2015; 94e1945
- Post-radiation plasma Epstein-Barr virus DNA and local clinical remission after radical intensity-modulated radiation therapy for nasopharyngeal carcinoma.Clin Oncol. 2016; 28: 42-49
- Epstein-Barr virus DNA level a novel prognostic factor in nasopharyngeal carcinoma: a meta-analysis.Medicine (Baltim). 2016; 95e5130
- Establishment and validation of prognostic nomograms for endemic nasopharyngeal carcinoma.J Natl Canc Inst. 2015; 108: djv291
- Prognostic value of plasma Epstein-Barr virus DNA for local and regionally advanced nasopharyngeal carcinoma treated with cisplatin-based concurrent chemoradiotherapy in intensity-modulated radiotherapy era.Medicine (Baltim). 2016; 95e2642
- Circulating EBV DNA, globulin and nodal size predict distant metastasis after intensity-modulated radiotherapy in stage II nasopharyngeal carcinoma.J Canc. 2016; 7: 664-670
- Long-term clinical outcome in nasopharyngeal carcinoma patients with post-radiation persistently detectable plasma EBV DNA.Oncotarget. 2016; 7: 42608-42616
- Plasma Epstein-Barr viral DNA complements TNM classification of nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy.Oncotarget. 2016; 7: 6221-6230
- Risk stratification based on change in plasma Epstein-Barr virus DNA load after treatment in nasopharyngeal carcinoma.Oncotarget. 2016; 7: 9576-9585
- Levels of plasma Epstein-Barr virus DNA prior and subsequent to treatment predicts the prognosis of nasopharyngeal carcinoma.Oncol Lett. 2015; 10: 2888-2894
- Analysis of plasma Epstein-Barr virus DNA to screen for nasopharyngeal cancer.N Engl J Med. 2017; 377: 513-522
- Prognostication of serial post-intensity-modulated radiation therapy undetectable plasma EBV DNA for nasopharyngeal carcinoma.Oncotarget. 2017; 8: 5292-5308
- Establishing and applying nomograms based on the 8th edition of the UICC/AJCC staging system to select patients with nasopharyngeal carcinoma who benefit from induction chemotherapy plus concurrent chemoradiotherapy.Oral Oncol. 2017; 69: 99-107
- Prognostic value of plasma Epstein-Barr virus DNA level during posttreatment follow-up in the patients with nasopharyngeal carcinoma having undergone intensity-modulated radiotherapy.Chin J Canc. 2017; 36: 87
- Prognostic role of plasma Epstein-Barr virus DNA load for nasopharyngeal carcinoma: a meta-analysis.Clin Invest Med. 2017; 40: E1-E12
- Combination of tumor volume and Epstein-Barr virus DNA improved prognostic stratification of stage II nasopharyngeal carcinoma in the intensity modulated radiotherapy era: a large-scale cohort study.Canc Res Treat. 2018; 50: 861-871
- Prevalence and significance of plasma Epstein-Barr Virus DNA level in nasopharyngeal carcinoma.J Radiat Res. 2017; 58: 509-516
- Analysis of plasma Epstein-Barr virus DNA in nasopharyngeal cancer after chemoradiation to identify high-risk patients for adjuvant chemotherapy: a randomized controlled trial.J Clin Oncol. 2018; https://doi.org/10.1200/JCO.2018.77.7847
- Prognostic value of plasma EBV DNA for nasopharyngeal cancer patients during treatment with intensity-modulated radiation therapy and concurrent chemotherapy.Radiol Oncol. 2018; 52: 195-203
- Surrogate endpoints shortening the therapeutic evaluation duration for different subgroups of patients with nasopharyngeal carcinoma receiving intensity-modulated radiotherapy: a retrospective analysis of 830 patients stratified by the 8th edition of the UICC/AJCC staging system and plasma Epstein-Barr viral.J Canc. 2018; 9: 3352-3360
- Prognostic nomogram for patients with Nasopharyngeal Carcinoma incorporating hematological biomarkers and clinical characteristics.Int J Biol Sci. 2018; 14: 549-556
- Pre-treatment serum amyloid A and C-reactive protein comparing with Epstein-Barr virus DNA as prognostic indicators in patients with nasopharyngeal carcinoma: a prospective study.Canc Res Treat. 2018; 50: 701-711
- Dynamic changes in plasma Epstein-Barr virus DNA load during treatment have prognostic value in nasopharyngeal carcinoma: a retrospective study.Canc Med. 2018; 7: 1110-1117
- The plasma Epstein-Barr virus DNA level guides precision treatment for nasopharyngeal carcinoma in the intensity-modulated radiotherapy era: a large population-based cohort study from an endemic area.Ther Adv Med Oncol. 2018; 101758835918782331
- Molecular prognostic value of circulating Epstein-Barr viral DNA in nasopharyngeal carcinoma: a meta-analysis of 27,235 cases in the endemic area of Southeast Asia.Genet Test Mol Biomarkers. 2019; 23: 448-459
- The addition of pre-treatment plasma Epstein-Barr virus DNA into the eighth edition of nasopharyngeal cancer TNM stage classification.Int J Canc. 2019; 144: 1713-1722
- Proposed modifications and incorporation of plasma Epstein-Barr virus DNA improve the TNM staging system for Epstein-Barr virus-related nasopharyngeal carcinoma.Cancer. 2019; 125: 79-89
- Liquid biopsy tracking during sequential chemo-radiotherapy identifies distinct prognostic phenotypes in nasopharyngeal carcinoma.Nat Commun. 2019; 10: 3941
- Prognostic value of gross tumor regression and plasma Epstein Barr Virus DNA levels at the end of intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma.Radiother Oncol. 2019; 132: 223-229
- Negative plasma Epstein-Barr virus DNA nasopharyngeal carcinoma in an endemic region and its influence on liquid biopsy screening programmes.Br J Canc. 2019; 121: 690-698
- Identifying optimal candidates for local treatment of the primary tumor among patients with de novo metastatic nasopharyngeal carcinoma: a retrospective cohort study based on Epstein-Barr virus DNA level and tumor response to palliative chemotherapy.BMC Canc. 2019; 19: 92
- Combining pre-treatment plasma Epstein-Barr virus DNA level and cervical node necrosis improves prognostic stratification in patients with nasopharyngeal carcinoma: a cohort study.Canc Med. 2019; 8: 6841-6852
- Comparison between the seventh and eighth edition of the AJCC/UICC staging system for nasopharyngeal cancer integrated with pre-treatment plasma Epstein-Barr virus DNA level in a non-Chinese population: secondary analysis from a prospective randomized trial.Jpn J Clin Oncol. 2019; 49: 1100-1113
- Clinical characteristics and prognostic value of pre-retreatment plasma Epstein-Barr virus DNA in locoregional recurrent nasopharyngeal carcinoma.Canc Med. 2019; 8: 4633-4643
- Plasma epstein-barr virus DNA load after induction chemotherapy predicts outcome in locoregionally advanced nasopharyngeal carcinoma.Int J Radiat Oncol Biol Phys. 2019; 104: 355-361
- Value of early evaluation of treatment response using 18F-FDG PET/CT parameters and the Epstein-Barr virus DNA load for prediction of outcome in patients with primary nasopharyngeal carcinoma.Eur J Nucl Med Mol Imag. 2019; 46: 650-660
- Relationship of circulating tumor cells and Epstein–Barr virus DNA to progression-free survival and overall survival in metastatic nasopharyngeal carcinoma patients.Int J Canc. 2019; 145: 2873-2883
- Prognostication of half-life clearance of plasma EBV DNA in previously untreated non-metastatic nasopharyngeal carcinoma treated with radical intensity-modulated radiation therapy.Front Oncol. 2020; 10: 1417
- Neoadjuvant or adjuvant chemotherapy plus concurrent CRT versus concurrent CRT alone in the treatment of nasopharyngeal carcinoma: a study based on EBV DNA.J Natl Compr Canc Netw. 2019; 17: 703-710
- Clinical characteristics and prognostic factors of early and late recurrence after definitive radiotherapy for nasopharyngeal carcinoma.Front Oncol. 2020; 10: 1469
- Risk stratification for nasopharyngeal carcinoma: a real-world study based on locoregional extension patterns and Epstein-Barr virus DNA load.Ther Adv Med Oncol. 2020; 121758835920932052
- Predicting progression-free survival using MRI-based radiomics for patients with nonmetastatic nasopharyngeal carcinoma.Front Oncol. 2020; 10: 618
- Clinical implications of plasma Epstein-Barr virus DNA in children and adolescent nasopharyngeal carcinoma patients receiving intensity-modulated radiotherapy.Front Oncol. 2020; 10: 356
- Integrating postradiotherapy plasma Epstein-Barr virus DNA and TNM stage for risk stratification of nasopharyngeal carcinoma to adjuvant therapy.Ann Oncol. 2020; 31: 769-779
- Establishing M1 stage subdivisions by incorporating radiological features and Epstein-Barr virus DNA for metastatic nasopharyngeal carcinoma.Ann Transl Med. 2020; 8: 83
- Prognostic potential of liquid biopsy tracking in the posttreatment surveillance of patients with nonmetastatic nasopharyngeal carcinoma.Cancer. 2020; 126: 2163-2173
- Pretreatment 18F-FDG-PET/CT texture parameters provide complementary information to Epstein-Barr virus DNA titers in patients with metastatic nasopharyngeal carcinoma.Oral Oncol. 2020; 104: 104628
- Effects of oral maintenance chemotherapy and predictive value of circulating EBV DNA in metastatic nasopharyngeal carcinoma.Canc Med. 2020; 9: 2732-2741
- Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients.Clin Infect Dis. 2001; 33: 139-144
- Cost-effectiveness of nasopharyngeal carcinoma screening with Epstein-Barr virus polymerase chain reaction or serology in high-incidence populations worldwide.J Natl Canc Inst. 2020; ([Online ahead of print]): djaa198https://doi.org/10.1093/jnci/djaa198
- Quantitative analysis of the transrenal excretion of circulating EBV DNA in nasopharyngeal carcinoma patients.Clin Canc Res. 2008; 14: 4809-4813
- NRG-HN001 protocol information randomized phase II and phase III studies of individualized treatment for nasopharyngeal carcinoma based on biomarker Epstein Barr Virus (EBV) deoxyribonucleic acid (DNA). 2020 ([cited 2015 Aug 20])https://www.nrgoncology.org/Clinical-Trials/Protocol-TableDate accessed: December 31, 2020
- Significance of cell-free Epstein–Barr virus DNA in monitoring prognosis of nasopharyngeal carcinoma.Ai Zheng. 2003; 22: 302-306
- Disparity of sensitivities in detection of radiation-naive and postirradiation recurrent nasopharyngeal carcinoma of the undifferentiated type by quantitative analysis of circulating Epstein–Barr virus DNA.Clin Canc Res. 2003; 9: 3431-3434
- Clinical scenario of EBV DNA follow-up in patients of treated localized nasopharyngeal carcinoma.Oral Oncol. 2013; 49: 620-625
- An international collaboration to harmonize the quantitative plasma Epstein-Barr virus DNA assay for future biomarker-guided trials in nasopharyngeal carcinoma.Clin Canc Res. 2013; 19: 2208-2215
- Clinical utility of Epstein-Barr virus DNA testing in the treatment of nasopharyngeal carcinoma patients.Int J Radiat Oncol Biol Phys. 2017; 98: 996-1001
- Ambient temperature and screening for nasopharyngeal cancer.N Engl J Med. 2018; 378: 962-963
- The biology and clinical utility of EBV monitoring in blood.Curr Top Microbiol Immunol. 2015; 391: 475-499
- Sequencing-based counting and size profiling of plasma Epstein-Barr virus DNA enhance population screening of nasopharyngeal carcinoma.Proc Natl Acad Sci U S A. 2018; 115: E5115-E5124
- Circulating tumor DNA for personalized lung cancer monitoring.BMC Med. 2017; 15: 157
- In regard to Kim et al.Int J Radiat Oncol Biol Phys. 2017; 99: 1306-1307
- Evaluation of circulating EBV microRNA BART2-5p in facilitating early detection and screening of nasopharyngeal carcinoma.Int J Canc. 2018; 143: 3209-3217
- Circulating tumor cells: a valuable marker of poor prognosis for advanced nasopharyngeal carcinoma.Mol Med. 2019; 25: 50
- Detection and clinical significance of circulating tumor cells in patients with nasopharyngeal carcinoma.Oncol Lett. 2019; 18: 2537-2547
- Clinical utility of serial analysis of circulating tumour cells for detection of minimal residual disease of metastatic nasopharyngeal carcinoma.Br J Canc. 2020; 123: 114-125
- Distribution and clinical significance of circulating tumor cells in nasopharyngeal carcinoma.Jpn J Clin Oncol. 2016; 46: 622-630
Article info
Publication history
Published online: June 18, 2021
Accepted:
May 9,
2021
Received in revised form:
May 2,
2021
Received:
March 18,
2021
Footnotes
☆This article was written by members and invitees of the International Head and Neck Scientific Group (www.IHNSG.com).
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
