Detectable or rising plasma EBV-DNA (BIO-EBV-DNA, quantitative PCR) after completion of d...
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | RF-NPC-EBV-DNA-POST-TREATMENT-SURVEILLANCE |
|---|---|
| Tipo | Señal de alerta |
| Situación | reviewed 2026-07-11 | pending_clinical_signoff |
| Enfermedades | DIS-NPC |
| Fuentes | SRC-EBV-DNA-NPC-LIN-2004 SRC-NCCN-HNSCC-2025 |
Origen de la bandera roja
| Definición | Detectable or rising plasma EBV-DNA (BIO-EBV-DNA, quantitative PCR) after completion of definitive treatment (concurrent chemoradiation +/- induction, or systemic 1L therapy) for nasopharyngeal carcinoma. Post-treatment plasma EBV-DNA is a validated prognostic/surveillance biomarker in NPC — persistent detectability or a rising trend can precede radiographic relapse by weeks to months, and should prompt accelerated re-staging workup rather than waiting for the routine imaging interval. |
|---|---|
| Dirección clínica | investigación |
| Categoría | transformación-progreso |
Lógica de activación
{
"any_of": [
{
"finding": "post_treatment_ebv_dna_detectable",
"value": true
},
{
"finding": "post_treatment_ebv_dna_rising",
"value": true
}
],
"type": "biomarker_threshold"
}
Notas
Informational/surveillance-stage RedFlag — NOT currently wired into ALGO-NPC-1L's decision tree (that algorithm covers 1L treatment selection only; no dedicated NPC post-treatment-surveillance or 2L/relapse algorithm has been authored yet — Phase 4 backlog item). Referenced from IND-NPC-1L-LOCALLY-ADVANCED-CCRT and IND-NPC-1L-METASTATIC-GC-PD1 notes as the biomarker basis for post-treatment monitoring. Underlying quantitative biomarker: BIO-EBV-DNA (existing entity — reused, not duplicated), measured via TEST-EBV-VIRAL-LOAD. Finding keys post_treatment_ebv_dna_detectable / post_treatment_ebv_dna_rising are NEW free-text finding keys — no questionnaire currently exists for DIS-NPC to populate them (quest_npc_*.yaml absent), consistent with the "honest finding" / "mechanical rewire" pattern used elsewhere in this KB when a finding key is asserted before its questionnaire wiring exists. STUB pending Clinical Co-Lead sign-off (CHARTER §6.1, dev-mode-exempted).
Utilizado por
Algoritmos
ALGO-NPC-1L- ALGO-NPC-1L
Enfermedad
DIS-NPC- Carcinoma nasofaríngeo (NPC)
Indicación
IND-NPC-1L-LOCALLY-ADVANCED-CCRT- IND-NPC-1L-LOCALLY-ADVANCED-CCRT
Fuentes
SRC-EBV-DNA-NPC-LIN-2004- Cuantificación del ADN del virus de Epstein-Barr en plasma en pacientes con nasofaríngeo avanzado...