Chih-Wen Twu1,2, Po-Ju Lin3, Hsiao-Hui Tsou4,5, Yi-Chun Liu6, Rong-San Jiang7, Kai-Li Liang7, Tian-Yun Lin7, Wen-Yi Wang8, Jin-Ching Lin3,6,9. 1. Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan. 2. College of Medicine, National Chung Hsing University, Taichung, Taiwan. 3. Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan. 4. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. 5. Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan. 6. Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan. 7. Department of Otorhinolaryngology - Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan. 8. Department of Nursing, Hung Kuang University, Taichung, Taiwan. 9. Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.
Abstract
BACKGROUND: We investigated the survival impact and toxicity of maintenance metronomic chemotherapy in patients with metastatic/recurrent nasopharyngeal carcinoma (met/rec NPC). METHODS: Ninety-eight patients with met/rec NPC were first salvaged by IV cisplatin-based chemotherapy and showed nonprogression disease; then maintenance metronomic chemotherapy for at least 12 months was recommended. We analyzed the treatment outcome between patients who received (n = 51) and did not receive (n = 47) maintenance chemotherapy. RESULTS: Baseline patient characteristics showed no significant differences between both arms. Median overall survival for patients with and without maintenance chemotherapy was 36.0 and 12.3 months, respectively (p < 0.0001). Similarly, median progression-free survival was 24.7 and 7.3 months, respectively (p < 0.0001). Furthermore, toxicities during maintenance oral chemotherapy period were usually mild. Transient grade 3 leucopenia (9.8%), anemia (3.9%), thrombocytopenia (7.8%), and no grade 4 toxicity were observed. CONCLUSION: After IV salvage chemotherapy, maintenance oral metronomic chemotherapy significantly improved overall and progression-free survivals while demonstrating low toxicity in patients with met/rec NPC.
BACKGROUND: We investigated the survival impact and toxicity of maintenance metronomic chemotherapy in patients with metastatic/recurrent nasopharyngeal carcinoma (met/rec NPC). METHODS: Ninety-eight patients with met/rec NPC were first salvaged by IV cisplatin-based chemotherapy and showed nonprogression disease; then maintenance metronomic chemotherapy for at least 12 months was recommended. We analyzed the treatment outcome between patients who received (n = 51) and did not receive (n = 47) maintenance chemotherapy. RESULTS: Baseline patient characteristics showed no significant differences between both arms. Median overall survival for patients with and without maintenance chemotherapy was 36.0 and 12.3 months, respectively (p < 0.0001). Similarly, median progression-free survival was 24.7 and 7.3 months, respectively (p < 0.0001). Furthermore, toxicities during maintenance oral chemotherapy period were usually mild. Transient grade 3 leucopenia (9.8%), anemia (3.9%), thrombocytopenia (7.8%), and no grade 4 toxicity were observed. CONCLUSION: After IV salvage chemotherapy, maintenance oral metronomic chemotherapy significantly improved overall and progression-free survivals while demonstrating low toxicity in patients with met/rec NPC.