■探讨在局部晚期鼻咽癌(LANPC)中使用节拍S1辅助化疗的有效性和安全性。
■我们回顾性收集了2016年1月至2021年12月期间诊断为LANPC的患者的数据。所有患者均接受诱导化疗和同步放化疗,有或没有节拍化疗(MC)。记录MC期间的毒性。卡方检验,Kaplan-Meier方法,倾向得分匹配(PSM),采用Cox比例风险模型进行统计分析。
■共确定了474名患者,包括64例(13.5%)和410例(83.5%)有或没有接受MC的患者,分别。接受节拍S1的患者3年局部无复发生存率(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)与没有节拍S1的人相比。多变量预后分析显示,节律性S1被确定为与更好的DMFS相关的独立预后因素(风险比[HR]0.074,p=0.010),DFS(HR0.103,p=0.002)和OS(HR0.127,P=0.042),但不在LRFS中(p=0.071)。使用PSM发现了类似的结果。在节拍S1组中观察到的常见不良事件包括白细胞减少症,中性粒细胞减少症,总胆红素增加,厌食症,皮疹/脱皮,和色素沉着过度。所有发生不良事件的患者均为1-2级。
■值得进行一项随机对照试验,以评估节拍S1对LANPC的生存结局和毒性的影响。
UNASSIGNED: To investigate the efficacy and safety of using metronomic S1 adjuvant chemotherapy in locoregionally advanced nasopharyngeal carcinoma (LANPC).
UNASSIGNED: 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.
UNASSIGNED: 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 S1 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 S1. The multivariate prognostic analysis revealed that metronomic S1 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 S1 group included leukopenia, neutropenia, increased total bilirubin, anorexia, rash/desquamation, and hyperpigmentation. All patients with adverse events were grade 1-2.
UNASSIGNED: It is worth conducting a randomized controlled trial to assess the effect of metronomic S1 on survival outcomes and toxicities of LANPC.