The role of capecitabine as maintenance therapy in de novo metastatic nasopharyngeal carcinoma:A propensity score matching study  

作　　者：Xue-Song Sun Sai-Lan Liu Yu-Jing Liang Qiu-Yan Chen Xiao-Yun Li Lin-Quan Tang Hai-Qiang Mai 

机构地区：[1]Department of Nasopharyngeal Carcinoma,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy,Sun Yat-sen University Cancer Center,Guangzhou,Guangdong 510060,P.R.China

出　　处：《Cancer Communications》2020年第1期32-42,共11页癌症通讯（英文）

基　　金：National Key R&D Program of China,Grant/Award Numbers:2016YFC0902003,2017YFC1309003,2017YFC0908500;National Natural Science Foundation of China,Grant/Award Numbers:81425018,81672868,81602371;Sun Yat-sen University Clinical Research 5010 Program,Grant/Award Numbers:201707020039,2014A020212103,16zxyc02;Sci-Tech Project Foundation of Guangzhou City,Grant/Award Number:201707020039;National Key Basic Research Program of China,Grant/Award Number:2013CB910304;Special Support Plan of Guangdong Province,Grant/Award Number:2014TX01R145;Sci-Tech Project Foundation of Guangdong Province,Grant/Award Number:2014A020212103;Health&Medical Collaborative Innovation Project of Guangzhou City,Grant/Award Number:201400000001;National Science&Technology Pillar Program during the Twelfth Five-year Plan Period,Grant/Award Number:2014BAI09B10;PhD Start-up Fund of Natural Science Foundation of Guangdong Province,China,Grant/Award Number:2016A030310221;cultivation foundation for the junior teachers in Sun Yat-sen University,Grant/Award Number:16ykpy28;foundation for major projects and new cross subjects in Sun Yat-sen University,Grant/Award Number:16ykjc38。

摘　　要：Background:Capecitabine was previously used as a second-line or salvage therapy for metastatic nasopharyngeal carcinoma(NPC)and has shown satisfactory curative effect as maintenance therapy in other metastatic cancers.This study aimed to explore the role of capecitabine as maintenance therapy in de novo metastatic NPC patients with different plasma Epstein-Barr virus(EBV)DNA levels before treatment.Methods:We selected de novo metastatic NPC patients treated with locoregional radiotherapy(LRRT)for this retrospective study.The propensity score matching(PSM)was applied to balance potential confounders between patients who underwent capecitabine maintenance therapy and those who did not with a ratio of 1:3.Overall survival(OS)was the primary endpoint.The association between capecitabine maintenance therapy and survival was assessed using the log-rank test and a Cox proportional hazard model.Results:Among all patients eligible for this study,64 received capecitabine maintenance therapy after LRRT.After PSM,192 patients were identified in the nonmaintenance group.In the matched cohort,patients treated with capecitabine achieved a higher 3-year OS rate compared with patients in the non-maintenance group(68.5%vs.61.8%,P=0.037).Multivariate analysis demonstrated that capecitabine maintenance therapy was an independent prognostic factor.In subgroup analysis,3-year OS rate was comparable between the maintenance and non-maintenance groups in patients with high pretreatment EBV DNA levels(˃30,000 copies/mL)(54.8%vs.45.8%,P=0.835),whereas patients with low pretreatment EBV DNA levels(≤30,000 copies/mL)could benefit from capecitabine maintenance therapy in OS(90.0%vs.68.1%,P=0.003).Conclusion:Capecitabine maintenance therapy may be superior to non-maintenance therapy in prolonging OS for de novo metastatic NPC patients with pretreatment EBV DNA≤30,000 copies/mL.groups in patients with high pretreatment EBV DNA levels(˃30,000 copies/mL)(54.8%vs.45.8%,P=0.835),whereas patients with low pretreatment EBV DNA levels(≤30,000

关 键 词：CAPECITABINE de novo Epstein-Barr virus LOCOREGIONAL maintenance therapy nasopharyngeal carcinoma propensity score matching RADIOTHERAPY survival 

分 类 号：R73[医药卫生—肿瘤]