ArticleInfectious agents and cancer2025
Metronomic chemotherapy in locoregionally advanced nasopharyngeal carcinoma with residual EBV-DNA after induction chemotherapy.
Article in Infectious agents and cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo analyze outcomes and evaluate the survival benefits of metronomic chemotherapy (MC) with S-1 in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with residual EBV-DNA after induction chemotherapy (IC).
methodsWe retrospectively included patients diagnosed with LANPC between October 2015 and August 2021. All patients were treated with IC and had residual EBV-DNA after IC. Chi-square test, Kaplan-Meier methods, and Cox proportional hazards model were used for statistical analyses.
resultsA total of 103 patients were identified, including 20 (19.4%) who received MC using S-1 for one year. Among these patients, 40 experienced disease progression, including 12 with locoregional recurrence (30.0%), 24 with distant metastasis (60.0%), and 4 with both locoregional recurrence and distant metastasis (10.0%). The 5-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 81.3%, 70.7%, 52.8%, and 72.1%, respectively. Multivariate prognostic analysis showed that post-IC residual EBV-DNA levels were independent prognostic factors for DMFS and PFS. Patients with EBV-DNA levels > 90 copies/mL had worse DMFS (hazard ratio [HR] 4.978, 95% confidence interval [CI] 1.413-17.535, P = 0.012) and PFS (HR 3.679, 95% CI 1.592-8.499, P = 0.002). Additionally, receiving MC was an independent prognostic factor for PFS and OS. Patients who received MC had better PFS (HR 0.310, 95% CI 0.120-0.802, P = 0.016) and OS (HR 0.100, 95% CI 0.013-0.745, P = 0.025).
conclusionsOur study highlights the poorer survival outcomes observed in LANPC patients with residual EBV-DNA levels following IC, as well as the potential survival advantages of MC in this subgroup. CLINICAL TRIAL NUMBER: Not applicable.
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