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
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。
