Metronomic chemotherapy in locoregionally advanced nasopharyngeal carcinoma with residual EBV-DNA after induction chemotherapy.

IF 2.8 2区医学 Q3 IMMUNOLOGY

Infectious Agents and Cancer Pub Date : 2025-09-24 DOI:10.1186/s13027-025-00694-8

Lin-Feng Guo, Liu-Yun Gong, Qin Lin, San-Gang Wu

{"title":"Metronomic chemotherapy in locoregionally advanced nasopharyngeal carcinoma with residual EBV-DNA after induction chemotherapy.","authors":"Lin-Feng Guo, Liu-Yun Gong, Qin Lin, San-Gang Wu","doi":"10.1186/s13027-025-00694-8","DOIUrl":null,"url":null,"abstract":"Purpose: To analyze outcomes and evaluate the survival benefits of metronomic chemotherapy (MC) with S-1 in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with residual EBV-DNA after induction chemotherapy (IC).Methods: We retrospectively included patients diagnosed with LANPC between October 2015 and August 2021. All patients were treated with IC and had residual EBV-DNA after IC. Chi-square test, Kaplan-Meier methods, and Cox proportional hazards model were used for statistical analyses.Results: A total of 103 patients were identified, including 20 (19.4%) who received MC using S-1 for one year. Among these patients, 40 experienced disease progression, including 12 with locoregional recurrence (30.0%), 24 with distant metastasis (60.0%), and 4 with both locoregional recurrence and distant metastasis (10.0%). The 5-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 81.3%, 70.7%, 52.8%, and 72.1%, respectively. Multivariate prognostic analysis showed that post-IC residual EBV-DNA levels were independent prognostic factors for DMFS and PFS. Patients with EBV-DNA levels > 90 copies/mL had worse DMFS (hazard ratio [HR] 4.978, 95% confidence interval [CI] 1.413-17.535, P = 0.012) and PFS (HR 3.679, 95% CI 1.592-8.499, P = 0.002). Additionally, receiving MC was an independent prognostic factor for PFS and OS. Patients who received MC had better PFS (HR 0.310, 95% CI 0.120-0.802, P = 0.016) and OS (HR 0.100, 95% CI 0.013-0.745, P = 0.025).Conclusions: Our study highlights the poorer survival outcomes observed in LANPC patients with residual EBV-DNA levels following IC, as well as the potential survival advantages of MC in this subgroup.Clinical trial number: Not applicable.","PeriodicalId":13568,"journal":{"name":"Infectious Agents and Cancer","volume":"20 1","pages":"64"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461949/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Agents and Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13027-025-00694-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To analyze outcomes and evaluate the survival benefits of metronomic chemotherapy (MC) with S-1 in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients with residual EBV-DNA after induction chemotherapy (IC).

Methods: We retrospectively included patients diagnosed with LANPC between October 2015 and August 2021. All patients were treated with IC and had residual EBV-DNA after IC. Chi-square test, Kaplan-Meier methods, and Cox proportional hazards model were used for statistical analyses.

Results: A total of 103 patients were identified, including 20 (19.4%) who received MC using S-1 for one year. Among these patients, 40 experienced disease progression, including 12 with locoregional recurrence (30.0%), 24 with distant metastasis (60.0%), and 4 with both locoregional recurrence and distant metastasis (10.0%). The 5-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 81.3%, 70.7%, 52.8%, and 72.1%, respectively. Multivariate prognostic analysis showed that post-IC residual EBV-DNA levels were independent prognostic factors for DMFS and PFS. Patients with EBV-DNA levels > 90 copies/mL had worse DMFS (hazard ratio [HR] 4.978, 95% confidence interval [CI] 1.413-17.535, P = 0.012) and PFS (HR 3.679, 95% CI 1.592-8.499, P = 0.002). Additionally, receiving MC was an independent prognostic factor for PFS and OS. Patients who received MC had better PFS (HR 0.310, 95% CI 0.120-0.802, P = 0.016) and OS (HR 0.100, 95% CI 0.013-0.745, P = 0.025).

Conclusions: Our study highlights the poorer survival outcomes observed in LANPC patients with residual EBV-DNA levels following IC, as well as the potential survival advantages of MC in this subgroup.

Clinical trial number: Not applicable.

查看原文本刊更多论文

局部进展期鼻咽癌诱导化疗后EBV-DNA残留的节律化疗。

目的：分析S-1节拍化疗（MC）在诱导化疗（IC）后残留EBV-DNA的局部晚期鼻咽癌（LANPC）患者的结局和生存获益。方法：回顾性纳入2015年10月至2021年8月期间诊断为LANPC的患者。所有患者均接受IC治疗，IC后均有EBV-DNA残留。采用卡方检验、Kaplan-Meier法和Cox比例风险模型进行统计分析。结果：共发现103例患者，其中20例（19.4%）采用S-1治疗1年。40例患者出现疾病进展，其中局部复发12例（30.0%），远处转移24例（60.0%），局部复发和远处转移4例（10.0%）。5年局部无复发生存率、远处无转移生存率（DMFS）、无进展生存率（PFS）和总生存率（OS）分别为81.3%、70.7%、52.8%和72.1%。多因素预后分析显示，ic后残留EBV-DNA水平是DMFS和PFS的独立预后因素。EBV-DNA水平为bb0 90拷贝/mL的患者DMFS（风险比[HR] 4.978, 95%可信区间[CI] 1.413-17.535, P = 0.012）和PFS（风险比[HR] 3.679, 95% CI 1.592-8.499, P = 0.002）较差。此外，接受MC治疗是PFS和OS的独立预后因素。接受MC治疗的患者有更好的PFS （HR 0.310, 95% CI 0.120-0.802, P = 0.016）和OS （HR 0.100, 95% CI 0.013-0.745, P = 0.025）。结论：我们的研究强调了在IC后残留EBV-DNA水平的LANPC患者中观察到的较差的生存结果，以及MC在该亚组中的潜在生存优势。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Infectious Agents and Cancer ONCOLOGY-IMMUNOLOGY

CiteScore

5.80

自引率

2.70%

发文量

期刊介绍： Infectious Agents and Cancer is an open access, peer-reviewed online journal that encompasses all aspects of basic, clinical, epidemiological and translational research providing an insight into the association between chronic infections and cancer. The journal welcomes submissions in the pathogen-related cancer areas and other related topics, in particular: • HPV and anogenital cancers, as well as head and neck cancers; • EBV and Burkitt lymphoma; • HCV/HBV and hepatocellular carcinoma as well as lymphoproliferative diseases; • HHV8 and Kaposi sarcoma; • HTLV and leukemia; • Cancers in Low- and Middle-income countries. The link between infection and cancer has become well established over the past 50 years, and infection-associated cancer contribute up to 16% of cancers in developed countries and 33% in less developed countries. Preventive vaccines have been developed for only two cancer-causing viruses, highlighting both the opportunity to prevent infection-associated cancers by vaccination and the gaps that remain before vaccines can be developed for other cancer-causing agents. These gaps are due to incomplete understanding of the basic biology, natural history, epidemiology of many of the pathogens that cause cancer, the mechanisms they exploit to cause cancer, and how to interrupt progression to cancer in human populations. Early diagnosis or identification of lesions at high risk of progression represent the current most critical research area of the field supported by recent advances in genomics and proteomics technologies.