Oral Metronomic Chemotherapy in Nasopharyngeal Carcinoma with Radiotherapy Interruptions: A Lesson Learned from the Lockdown Due to COVID-19.

Abstract

Purpose: Metronomic chemotherapy (MC) represents a therapeutic approach characterized by the long-term administration of chemotherapeutic agents at relatively low doses, with minimal or no drug-free intervals (US20150283237, CN111110681A). This study aimed to evaluate the treatment characteristics, prognosis, and efficacy of S-1 MC as a compensatory strategy for nasopharyngeal carcinoma (NPC) patients who experienced radiotherapy interruption (RI) during the COVID-19 pandemic.

Methods: This study included NPC patients who experienced RI due to the COVID-19 pandemic. Patient characteristics, details of treatment after RI, compensatory treatment, and survival outcomes were analyzed.

Results: A total of 8 patients were identified, with a median RI duration of 19 days. All patients received an additional fraction of radiotherapy due to the interruption. Following RI, all patients completed the recommended radiotherapy regimen and underwent comprehensive locoregional and systemic assessment three months post-treatment. Complete remission of the nasopharyngeal tumor and cervical lymph nodes was achieved in 7 (87.5%) patients. These patients were administered oral tegafur, gimeracil, and oteracil potassium (S-1) MC. All patients completed one year of MC without experiencing grade 3-4 adverse reactions. With a median follow-up of 34.4 months, no instances of disease recurrence were observed. The 2-year disease-free survival and overall survival were both 100%.

Conclusion: MC may serve as an effective compensatory treatment strategy for NPC patients experiencing RI. These findings offer valuable insights for future clinical trials involving NPC patients with RI due to various reasons.