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International recommendations for plasma Epstein-Barr virus DNA measurement in nasopharyngeal carcinoma in resource-constrained settings: lessons from the COVID-19 pandemic.


ABSTRACT: The effects of the COVID-19 pandemic continue to constrain health-care staff and resources worldwide, despite the availability of effective vaccines. Aerosol-generating procedures such as endoscopy, a common investigation tool for nasopharyngeal carcinoma, are recognised as a likely cause of SARS-CoV-2 spread in hospitals. Plasma Epstein-Barr virus (EBV) DNA is considered the most accurate biomarker for the routine management of nasopharyngeal carcinoma. A consensus statement on whether plasma EBV DNA can minimise the need for or replace aerosol-generating procedures, imaging methods, and face-to-face consultations in managing nasopharyngeal carcinoma is urgently needed amid the current pandemic and potentially for future highly contagious airborne diseases or natural disasters. We completed a modified Delphi consensus process of three rounds with 33 international experts in otorhinolaryngology or head and neck surgery, radiation oncology, medical oncology, and clinical oncology with vast experience in managing nasopharyngeal carcinoma, representing 51 international professional societies and national clinical trial groups. These consensus recommendations aim to enhance consistency in clinical practice, reduce ambiguity in delivering care, and offer advice for clinicians worldwide who work in endemic and non-endemic regions of nasopharyngeal carcinoma, in the context of COVID-19 and other airborne pandemics, and in future unexpected settings of severe resource constraints and insufficiency of personal protective equipment.

SUBMITTER: Lee VH 

PROVIDER: S-EPMC9704820 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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International recommendations for plasma Epstein-Barr virus DNA measurement in nasopharyngeal carcinoma in resource-constrained settings: lessons from the COVID-19 pandemic.

Lee Victor Ho-Fun VH   Adham Marlinda M   Ben Kridis Wala W   Bossi Paolo P   Chen Ming-Yuan MY   Chitapanarux Imjai I   Gregoire Vincent V   Hao Sheng Po SP   Ho Cheryl C   Ho Gwo Fuang GF   Kannarunimit Danita D   Kwong Dora Lai-Wan DL   Lam Ka-On KO   Lam Wai Kei Jacky WKJ   Le Quynh-Thu QT   Lee Anne Wing-Mui AW   Lee Nancy Y NY   Leung To-Wai TW   Licitra Lisa L   Lim Darren Wan-Teck DW   Lin Jin-Ching JC   Loh Kwok Seng KS   Lou Pei-Jen PJ   Machiels Jean-Pascal JP   Mai Hai-Qiang HQ   Mesía Ricard R   Ng Wai-Tong WT   Ngan Roger Kai-Cheong RK   Tay Joshua K JK   Tsang Raymond King-Yin RK   Tong Chi-Chung CC   Wang Hung-Ming HM   Wee Joseph T JT  

The Lancet. Oncology 20221201 12


The effects of the COVID-19 pandemic continue to constrain health-care staff and resources worldwide, despite the availability of effective vaccines. Aerosol-generating procedures such as endoscopy, a common investigation tool for nasopharyngeal carcinoma, are recognised as a likely cause of SARS-CoV-2 spread in hospitals. Plasma Epstein-Barr virus (EBV) DNA is considered the most accurate biomarker for the routine management of nasopharyngeal carcinoma. A consensus statement on whether plasma E  ...[more]

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