{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:16:02Z","timestamp":1788412562324,"version":"build-2803163510"},"reference-count":52,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"St. Baldricks\u2019 Foundation"},{"id":[{"id":"https:\/\/ror.org\/03h1gea69","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA180886"],"award-info":[{"award-number":["U10CA180886"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA180899"],"award-info":[{"award-number":["U10CA180899"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U24CA196173"],"award-info":[{"award-number":["U24CA196173"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN26100039"],"award-info":[{"award-number":["HHSN26100039"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1R50CA305079"],"award-info":[{"award-number":["1R50CA305079"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Children\u2019s Oncology Group Foundation"},{"DOI":"10.13039\/100016947","name":"Swim Across America","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016947","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/05d8ft347","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003287","name":"Rally Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100003287","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/01mkym489","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000090","name":"Department of Defense Congressionally Directed Medical Research Program Award","doi-asserted-by":"publisher","award":["CA220651"],"award-info":[{"award-number":["CA220651"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]},{"award":["CA220651"],"award-info":[{"award-number":["CA220651"]}],"id":[{"id":"https:\/\/ror.org\/03g2zjp07","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Parents\u2019 Foundation"},{"name":"Hilfe f\u00fcr krebskranke Kinder Aachen, e.V."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Pediatric nasopharyngeal carcinoma (NPC) is a very rare childhood cancer strongly associated with Epstein\u2013Barr virus (EBV) infection. We investigated the prognostic value of EBV DNA on staging and outcome in pediatric NPC from two large study centers, the Children\u2019s Oncology Group (COG) in North America and the German Society of Pediatric Oncology and Hematology (GPOH) in Europe. Methods: Samples collected from NPC patients treated on the COG study ARAR0331 between 2006 and 2012 and the GPOH NPC protocol between 2003 and 2021 were retrospectively analyzed for the level of available plasma (P-EBV) or whole-blood EBV DNA (WB-EBV), both pre-treatment and post-induction chemotherapy. Patients were dichotomized into high and low groups based on the median pre-treatment EBV value. Results: Pre-treatment EBV DNA levels from 102 patients (50 and 23 P-EBV DNA from the COG and GPOH, respectively, and 29 WB-EBV from GPOH) and post-induction EBV DNA levels from 61 patients (31 and 12 P-EBV DNA from the COG and GPOH, respectively, and 18 WB-EBV DNA from GPOH) were evaluated. Patient characteristics, including age and disease stage, were not associated with high and low P-EBV values in any cohort. Disease stage correlated with high EBV levels in the WB-EBV GPOH cohort (p = 0.014). Pre-treatment P-EBV and WB-EBV levels showed no significant association with 5-year event-free survival (EFS: COG p = 0.65, GPOH P-EBV: p = 0.08, GPOH WB-EBV: p = 0.75) or 5-year overall survival (OS: COG p = 0.90, GPOH P-EBV p = 0.17, GPOH WB-EBV p = 0.19). Conclusions: Our study could not establish a significant correlation between outcome and pre-treatment EBV DNA in pediatric NPC patients from non-endemic areas.<\/jats:p>","DOI":"10.3390\/cancers18172800","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:33:52Z","timestamp":1787942032000},"page":"2800","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Prognostic Relevance of Pre-Treatment Epstein\u2013Barr Virus Levels in Non-Endemic Pediatric Nasopharyngeal Carcinoma"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7377-0650","authenticated-orcid":false,"given":"Ahmed","family":"Farrag","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"},{"name":"Center for Integrative Oncology Aachen Bonn Cologne D\u00fcsseldorf, 52074 Aachen, Germany"},{"name":"Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut 71515, Egypt"},{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Children\u2019s Hospital of Central Switzerland, 6004 Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1532-9274","authenticated-orcid":false,"given":"Yanbo","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0516-6280","authenticated-orcid":false,"given":"Jin","family":"Piao","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA"},{"name":"Children\u2019s Oncology Group, Monrovia, CA 91016, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0115-8836","authenticated-orcid":false,"given":"Lindsay","family":"Younis","sequence":"additional","affiliation":[{"name":"Children\u2019s Oncology Group, Monrovia, CA 91016, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"visualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Hans-Joachim","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Justus Liebig University Giessen, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0960-7955","authenticated-orcid":false,"given":"Hans","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Tristan","family":"R\u00f6mer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"},{"name":"Center for Integrative Oncology Aachen Bonn Cologne D\u00fcsseldorf, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Allison","family":"Poore","sequence":"additional","affiliation":[{"name":"Biospecimen Research Group, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Christopher","family":"Szot","sequence":"additional","affiliation":[{"name":"Biospecimen Research Group, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s10555-024-10176-9","article-title":"Epidemiology of nasopharyngeal carcinoma: Current insights and future outlook","volume":"43","author":"Su","year":"2024","journal-title":"Cancer Metastasis Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1055\/s-0041-111180","article-title":"Diagnosis and Treatment of Nasopharyngeal Carcinoma in Children and Adolescents\u2014Recommendations of the GPOH-NPC Study Group","volume":"228","author":"Kontny","year":"2016","journal-title":"Klin. Padiatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/pbc.22521","article-title":"Differential features of nasopharyngeal carcinoma in children and adults: A SEER study","volume":"55","author":"Sultan","year":"2010","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"106218","DOI":"10.1016\/j.oraloncology.2022.106218","article-title":"Molecular characteristics of pediatric nasopharyngeal carcinoma using whole-exome sequencing","volume":"135","author":"Wu","year":"2022","journal-title":"Oral Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s00405-011-1562-6","article-title":"The incidence of Epstein-Barr virus in nasopharyngeal carcinoma of Jordanian patients","volume":"269","author":"Matalka","year":"2012","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/S0140-6736(15)00055-0","article-title":"Nasopharyngeal carcinoma","volume":"387","author":"Chua","year":"2016","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40880-019-0357-9","article-title":"The diagnostic and prognostic values of plasma Epstein-Barr virus DNA for residual cervical lymphadenopathy in nasopharyngeal carcinoma patients: A retrospective study","volume":"39","author":"Liu","year":"2019","journal-title":"Cancer Commun."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1007\/s00066-019-01461-6","article-title":"Adapted strategy to tumor response in childhood nasopharyngeal carcinoma: The French experience","volume":"195","author":"Jouin","year":"2019","journal-title":"Strahlenther. Onkol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1002\/ijc.31856","article-title":"The addition of pretreatment plasma Epstein-Barr virus DNA into the eighth edition of nasopharyngeal cancer TNM stage classification","volume":"144","author":"Lee","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.oraloncology.2017.04.015","article-title":"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","volume":"69","author":"Xu","year":"2017","journal-title":"Oral Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.ejca.2021.05.022","article-title":"A systematic review and recommendations on the use of plasma EBV DNA for nasopharyngeal carcinoma","volume":"153","author":"Lee","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e1945","DOI":"10.1097\/MD.0000000000001945","article-title":"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","volume":"94","author":"Shen","year":"2015","journal-title":"Medicine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3124","DOI":"10.1158\/1078-0432.CCR-24-3546","article-title":"One-Two Punch: Combining Chemotherapy and Immunotherapy to Decrease Radiation Dose and Related Toxicity in Children and Adolescents with Nasopharyngeal Carcinoma","volume":"31","author":"Dholaria","year":"2025","journal-title":"Clin. Cancer Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3369","DOI":"10.1200\/JCO.19.01276","article-title":"Treatment of Childhood Nasopharyngeal Carcinoma With Induction Chemotherapy and Concurrent Chemoradiotherapy: Results of the Children\u2019s Oncology Group ARAR0331 Study","volume":"37","author":"Carlos","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4892","DOI":"10.1002\/cncr.27395","article-title":"Multimodal treatment, including interferon beta, of nasopharyngeal carcinoma in children and young adults: Preliminary results from the prospective, multicenter study NPC-2003-GPOH\/DCOG","volume":"118","author":"Buehrlen","year":"2012","journal-title":"Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"R\u00f6mer, T., Franzen, S., Kravets, H., Farrag, A., Makowska, A., Christiansen, H., Eble, M.J., Timmermann, B., Staatz, G., and Mottaghy, F.M. (2022). Multimodal Treatment of Nasopharyngeal Carcinoma in Children, Adolescents and Young Adults-Extended Follow-Up of the NPC-2003-GPOH Study Cohort and Patients of the Interim Cohort. Cancers, 14.","DOI":"10.3390\/cancers14051261"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s00106-023-01404-9","article-title":"Combination of nivolumab with standard induction chemotherapy in children and adults with EBV-positive nasopharyngeal carcinoma: Protocol of a prospective multicenter phase 2 trial","volume":"72","author":"Vokuhl","year":"2024","journal-title":"HNO"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e845","DOI":"10.1097\/MD.0000000000000845","article-title":"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","volume":"94","author":"Zhang","year":"2015","journal-title":"Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.25011\/cim.v40i1.28049","article-title":"Prognostic role of plasma Epstein-Barr virus DNA load for nasopharyngeal carcinoma: A meta-analysis","volume":"40","author":"Liu","year":"2017","journal-title":"Clin. Investig. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"106229","DOI":"10.1016\/j.oraloncology.2022.106229","article-title":"Comparing BamHI-W and CE-marked assays to detect circulating Epstein-Barr Virus (EBV) DNA of nasopharyngeal cancer patients in a non-endemic area","volume":"135","author":"Taverna","year":"2022","journal-title":"Oral Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.jmoldx.2023.03.007","article-title":"Comparison of Real-Time PCR and Digital PCR for Detection of Plasma Epstein-Barr Virus DNA in Nasopharyngeal Carcinoma","volume":"25","author":"Miller","year":"2023","journal-title":"J. Mol. Diagn."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5827","DOI":"10.1007\/s00216-015-8773-4","article-title":"ddpcRquant: Threshold determination for single channel droplet digital PCR experiments","volume":"407","author":"Trypsteen","year":"2015","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/00007890-200109270-00006","article-title":"Patients at risk for development of posttransplant lymphoproliferative disorder: Plasma versus peripheral blood mononuclear cells as material for quantification of Epstein-Barr viral load by using real-time quantitative polymerase chain reaction","volume":"72","author":"Wagner","year":"2001","journal-title":"Transplantation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1101\/gr.6.10.986","article-title":"Real time quantitative PCR","volume":"6","author":"Heid","year":"1996","journal-title":"Genome Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1002\/jmv.21095","article-title":"Rapid quantitative PCR assays for the simultaneous detection of herpes simplex virus, varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and human herpesvirus 6 DNA in blood and other clinical specimens","volume":"80","author":"Engelmann","year":"2008","journal-title":"J. Med. Virol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1007\/s00405-015-3620-y","article-title":"Can Epstein-Barr virus DNA load in nasopharyngeal brushings or whole blood predict recurrent nasopharyngeal carcinoma in a non-endemic region? A prospective nationwide study of the Dutch Head and Neck Oncology Cooperative Group","volume":"273","author":"Stoker","year":"2016","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1002\/ijc.33293","article-title":"Clinicopathological and prognostic features of nasopharyngeal carcinoma in children and adolescents: A retrospective study of 196 cases in South China","volume":"148","author":"Zhang","year":"2021","journal-title":"Int. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1097\/MPH.0000000000001676","article-title":"Pediatric Nasopharyngeal Carcinoma: A Rare Tumor in a Developing Country-What Do We Learn?","volume":"42","author":"Zekri","year":"2020","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1016\/j.ijporl.2013.06.005","article-title":"Nasopharyngeal carcinoma in children and adolescents in an endemic area: A report of 185 cases","volume":"77","author":"Yan","year":"2013","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.oraloncology.2013.12.011","article-title":"Application of circulating plasma\/serum EBV DNA in the clinical management of nasopharyngeal carcinoma","volume":"50","author":"Yip","year":"2014","journal-title":"Oral Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1001\/jamaoto.2015.3217","article-title":"Factors Associated With Mortality in Pediatric vs Adult Nasopharyngeal Carcinoma","volume":"142","author":"Richards","year":"2016","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Zeng, Z., Chen, C., Guo, L., Zhang, C., Chen, L., Yuan, C., and Lu, L. (2020). Exploring the Optimal Chemotherapy Strategy for Locoregionally Advanced Children and Adolescent Nasopharyngeal Carcinoma Based on Pretreatment Epstein-Barr Virus DNA Level in the Era of Intensity Modulated Radiotherapy. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.600429"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Qiu, W., Lv, X., Guo, X., and Yuan, Y. (2020). Clinical Implications of Plasma Epstein-Barr Virus DNA in Children and Adolescent Nasopharyngeal Carcinoma Patients Receiving Intensity-Modulated Radiotherapy. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.00356"},{"key":"ref_34","first-page":"115","article-title":"Cancer statistics in China, 2015","volume":"66","author":"Chen","year":"2016","journal-title":"CA Cancer J. Clin."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1056\/NEJMoa1701717","article-title":"Analysis of Plasma Epstein-Barr Virus DNA to Screen for Nasopharyngeal Cancer","volume":"377","author":"Chan","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5414","DOI":"10.1200\/JCO.2006.07.7982","article-title":"Plasma Epstein-Barr viral deoxyribonucleic acid quantitation complements tumor-node-metastasis staging prognostication in nasopharyngeal carcinoma","volume":"24","author":"Leung","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s40880-017-0256-x","article-title":"Prognostic value of plasma Epstein-Barr virus DNA level during posttreatment follow-up in the patients with nasopharyngeal carcinoma having undergone intensity-modulated radiotherapy","volume":"36","author":"Li","year":"2017","journal-title":"Chin. J. Cancer"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"364","DOI":"10.5539\/gjhs.v7n3p364","article-title":"Expression of interleukin-8, interleukin-10 and Epstein-Barr viral-load as prognostic indicator in nasopharyngeal carcinoma","volume":"7","author":"Savitri","year":"2015","journal-title":"Glob. J. Health Sci."},{"key":"ref_39","first-page":"5431","article-title":"The whole-blood Epstein-Barr virus DNA can serve as a valuable molecular marker for diagnosis and prognosis prediction of nasopharyngeal carcinoma","volume":"13","author":"Zeng","year":"2023","journal-title":"Am. J. Cancer Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.radonc.2018.10.010","article-title":"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","volume":"132","author":"Liang","year":"2019","journal-title":"Radiother. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1038\/s41416-019-0575-6","article-title":"Negative plasma Epstein-Barr virus DNA nasopharyngeal carcinoma in an endemic region and its influence on liquid biopsy screening programmes","volume":"121","author":"Nicholls","year":"2019","journal-title":"Br. J. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1002\/ijc.32656","article-title":"Systematic comparison of plasma EBV DNA, anti-EBV antibodies and miRNA levels for early detection and prognosis of nasopharyngeal carcinoma","volume":"146","author":"Tan","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"18","DOI":"10.21037\/cco.2016.03.07","article-title":"Clinical utility of circulating Epstein-Barr virus DNA analysis for the management of nasopharyngeal carcinoma","volume":"5","author":"Fung","year":"2016","journal-title":"Chin. Clin. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5988","DOI":"10.1002\/cam4.1858","article-title":"Relationship between pretreatment concentration of plasma Epstein-Barr virus DNA and tumor burden in nasopharyngeal carcinoma: An updated interpretation","volume":"7","author":"Peng","year":"2018","journal-title":"Cancer Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1099\/jgv.0.000889","article-title":"Epstein-Barr virus biomarkers for nasopharyngeal carcinoma in non-endemic regions","volume":"98","author":"Gurtsevitch","year":"2017","journal-title":"J. Gen. Virol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13027-021-00353-8","article-title":"Circulating cell-free epstein-barr virus DNA levels and clinical features in Moroccan patients with nasopharyngeal carcinoma","volume":"16","author":"Gihbid","year":"2021","journal-title":"Infect. Agents Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1056\/NEJMoa032260","article-title":"Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma","volume":"350","author":"Lin","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s00405-019-05699-9","article-title":"Prognostic value of Epstein-Barr virus DNA level for nasopharyngeal carcinoma: A meta-analysis of 8128 cases","volume":"277","author":"Qu","year":"2020","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"861","DOI":"10.7150\/jca.17957","article-title":"Magnetic Resonance Imaging-Detected Tumor Residue after Intensity-Modulated Radiation Therapy and its Association with Post-Radiation Plasma Epstein-Barr Virus Deoxyribonucleic Acid in Nasopharyngeal Carcinoma","volume":"8","author":"Lv","year":"2017","journal-title":"J. Cancer"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1158\/1078-0432.CCR-09-2796","article-title":"Plasma EBV DNA clearance rate as a novel prognostic marker for metastatic\/recurrent nasopharyngeal carcinoma","volume":"16","author":"Wang","year":"2010","journal-title":"Clin. Cancer Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e2124721","DOI":"10.1001\/jamanetworkopen.2021.24721","article-title":"Assessment of Survival Model Performance Following Inclusion of Epstein-Barr Virus DNA Status in Conventional TNM Staging Groups in Epstein-Barr Virus-Related Nasopharyngeal Carcinoma","volume":"4","author":"Li","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Rzepka, M., Depka, D., Gospodarek-Komkowska, E., and Bogiel, T. (2023). Diagnostic Value of Whole-Blood and Plasma Samples in Epstein-Barr Virus Infections. 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