{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:40:00Z","timestamp":1747147200576,"version":"3.40.5"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T00:00:00Z","timestamp":1654646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013050","name":"Guangdong Provincial Applied Science and Technology Research and Development Program","doi-asserted-by":"publisher","award":["A2020606"],"award-info":[{"award-number":["A2020606"]}],"id":[{"id":"10.13039\/501100013050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Induction chemotherapy (IC) comprising docetaxel, cisplatin, and fluorouracil (TPF), combined with concurrent chemoradiotherapy (CCRT) effectively improves the survival rate of locally advanced nasopharyngeal carcinoma (LA\u2010NPC). Selecting patients whose risk of tumor recurrence and metastasis is high and the appropriate chemotherapy intensity is a concern. We combined tumor\u2010node\u2010metastasis staging with the load of Epstein\u2013Barr virus (EBV) after IC to select the individualized chemotherapy strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical data and prognostic factors of patients with stage III\u2013IV LA\u2010NPC treated with TPF IC combined with CCRT were analyzed retrospectively. The conventional treatment group received the standard three cycles TPF IC combined with CCRT. For the new treatment group, the cycles of IC were determined according to whether the EBV\u2010DNA disappeared completely after a certain course of IC, if so, subsequent IC was stopped and the chemoradiotherapy stage was entered. Propensity score matching (PSM) was performed at a ratio of 1:1 to balance baseline characteristics. Survival outcomes and adverse events between the conventional treatment group and the new method treatment group were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 256 patients, among whom 192 were matched successfully into 96 pairs. The patients were followed up for a median of 51\u2009months. The proportions of patients receiving three, two, and one cycle of IC after PSM in the routine and new treatment cohorts were 93.8%, 3.1%, 3.1% versus 21.9%, 49.0%, 24.0%, respectively. However, their 3\u2010year distant metastasis\u2010free survival, local recurrence\u2010free survival, progression\u2010free survival, and overall survival did not differ significantly. The incidence of grade 3\u20134 neutropenia toxicity in CCRT decreased significantly in patients receiving the new treatment method compared with that in the conventional treatment group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combining TNM stage and EBV\u2010DNA load after IC to determine the courses of IC in patients with LA\u2010NPC did not alter the curative effect but decreased toxicity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4899","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T10:03:07Z","timestamp":1654682587000},"page":"223-235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Can Epstein\u2013Barr virus\u2010deoxyribonucleic acid load after induction chemotherapy combined with American Joint Committee on Cancer stage determine the chemotherapy intensity of locally advanced nasopharyngeal carcinoma?"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9419-7673","authenticated-orcid":false,"given":"Qun","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiotherapy First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0617-3805","authenticated-orcid":false,"given":"Zhen\u2010Wei","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhuo\u2010Sheng","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Sun Yat\u2010sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer 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