Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
School of Medicine, Sun Yat-sen University, Shenzhen, China.
Cancer Res Treat. 2024 Oct;56(4):1058-1067. doi: 10.4143/crt.2023.1343. Epub 2024 Feb 19.
This study aimed to investigate the efficacy and safety of using metronomic S-1 adjuvant chemotherapy in locoregionally advanced nasopharyngeal carcinoma (LANPC).
We retrospectively collected data on patients diagnosed with LANPC between January 2016 and December 2021. All patients were treated with induction chemotherapy and concurrent chemoradiotherapy with or without metronomic chemotherapy (MC). Toxicities during MC were recorded. The chi-square test, Kaplan-Meier methods, propensity score matching (PSM), and Cox proportional hazards model were used for statistical analyses.
A total of 474 patients were identified, including 64 (13.5%) and 410 (83.5%) patients with or without receiving MC, respectively. Patients who received metronomic S-1 had significantly better 3-year locoregional recurrence-free survival (LRFS) (100% vs. 90.9%, p=0.038), distant metastasis-free survival (DMFS) (98.5% vs. 84.1%, p=0.002), disease-free survival (DFS) (98.4% vs. 77.5%, p < 0.001), and overall survival (OS) (98.0% vs. 87.7%, p=0.008) compared to those without metronomic S-1. The multivariate prognostic analysis revealed that metronomic S-1 was identified as an independent prognostic factor associated with better DMFS (hazard ratio [HR], 0.074; p=0.010), DFS (HR, 0.103; p=0.002) and OS (HR, 0.127; p=0.042), but not in LRFS (p=0.071). Similar results were found using PSM. Common adverse events observed in the metronomic S-1 group included leukopenia, neutropenia, increased total bilirubin, anorexia, rash/desquamation, and hyperpigmentation. All patients with adverse events were grade 1-2.
It is worth conducting a randomized controlled trial to assess the effect of metronomic S-1 on survival outcomes and toxicities of LANPC.
本研究旨在探讨节拍式 S-1 辅助化疗治疗局部晚期鼻咽癌（LANPC）的疗效和安全性。
我们回顾性收集了 2016 年 1 月至 2021 年 12 月期间诊断为 LANPC 的患者数据。所有患者均接受诱导化疗和同期放化疗，其中部分患者接受节拍式化疗（MC）。记录 MC 期间的毒性反应。采用卡方检验、Kaplan-Meier 方法、倾向评分匹配（PSM）和 Cox 比例风险模型进行统计学分析。
共纳入 474 例患者，其中 64 例（13.5%）和 410 例（83.5%）患者分别接受或未接受 MC。接受节拍式 S-1 治疗的患者 3 年局部区域无复发生存率（LRFS）（100% vs. 90.9%，p=0.038）、无远处转移生存率（DMFS）（98.5% vs. 84.1%，p=0.002）、无病生存率（DFS）（98.4% vs. 77.5%，p<0.001）和总生存率（OS）（98.0% vs. 87.7%，p=0.008）均显著优于未接受 MC 的患者。多因素预后分析显示，节拍式 S-1 是与更好的 DMFS（风险比 [HR]，0.074；p=0.010）、DFS（HR，0.103；p=0.002）和 OS（HR，0.127；p=0.042）相关的独立预后因素，但与 LRFS 无关（p=0.071）。使用 PSM 也得到了相似的结果。节拍式 S-1 组常见的不良反应包括白细胞减少、中性粒细胞减少、总胆红素升高、厌食、皮疹/脱屑和色素沉着过度。所有不良反应均为 1-2 级。
值得开展一项随机对照试验，以评估节拍式 S-1 对 LANPC 患者生存结局和毒性的影响。
