International recommendations for plasma Epstein-Barr virus DNA measurement in nasopharyngeal carcinoma in resource-constrained settings: lessons from the COVID-19 pandemic
Journal
The Lancet. Oncology
Journal Volume
23
Journal Issue
12
Date Issued
2022-12
Author(s)
Lee, Victor Ho-Fun
Adham, Marlinda
Ben Kridis, Wala
Bossi, Paolo
Chen, Ming-Yuan
Chitapanarux, Imjai
Gregoire, Vincent
Hao, Sheng Po
Ho, Cheryl
Ho, Gwo Fuang
Kannarunimit, Danita
Kwong, Dora Lai-Wan
Lam, Ka-On
Lam, Wai Kei Jacky
Le, Quynh-Thu
Lee, Anne Wing-Mui
Lee, Nancy Y
Leung, To-Wai
Licitra, Lisa
Lim, Darren Wan-Teck
Lin, Jin-Ching
Loh, Kwok Seng
Machiels, Jean-Pascal
Mai, Hai-Qiang
Mesía, Ricard
Ng, Wai-Tong
Ngan, Roger Kai-Cheong
Tay, Joshua K
Tsang, Raymond King-Yin
Tong, Chi-Chung
Wang, Hung-Ming
Wee, Joseph T
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.
Type
review