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This study aimed to explore the role of capecitabine as maintenance therapy in\n                      <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                      metastatic NPC patients with different plasma Epstein\u2010Barr virus (EBV) DNA levels before treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We selected\n                      <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                      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\u2010rank test and a Cox proportional hazard model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among all patients eligible for this study, 64 received capecitabine maintenance therapy after LRRT. After PSM, 192 patients were identified in the non\u2010maintenance group. In the matched cohort, patients treated with capecitabine achieved a higher 3\u2010year OS rate compared with patients in the non\u2010maintenance group (68.5%\u00a0vs. 61.8%,\n                      <jats:italic toggle=\"yes\">P\u00a0<\/jats:italic>\n                      =\u00a00.037). Multivariate analysis demonstrated that capecitabine maintenance therapy was an independent prognostic factor. In subgroup analysis, 3\u2010year OS rate was comparable between the maintenance and non\u2010maintenance groups in patients with high pretreatment EBV DNA levels (\u02c330,000 copies\/mL) (54.8%\u00a0vs. 45.8%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.835), whereas patients with low pretreatment EBV DNA levels (\u226430,000 copies\/mL) could benefit from capecitabine maintenance therapy in OS (90.0%\u00a0vs. 68.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Capecitabine maintenance therapy may be superior to non\u2010maintenance therapy in prolonging OS for\n                      <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                      metastatic NPC patients with pretreatment EBV DNA \u2264 30,000 copies\/mL.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cac2.12004","type":"journal-article","created":{"date-parts":[[2020,2,29]],"date-time":"2020-02-29T03:59:25Z","timestamp":1582948765000},"page":"32-42","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The role of capecitabine as maintenance therapy in\n                    <i>de novo<\/i>\n                    metastatic nasopharyngeal carcinoma: A propensity score matching study"],"prefix":"10.34133","volume":"40","author":[{"given":"Xue\u2010Song","family":"Sun","sequence":"first","affiliation":[{"name":"Sun Yat\u2010sen University Cancer Center","place":["Guangzhou, P. 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