{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T13:13:50Z","timestamp":1793106830687,"version":"4.5.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Res Clin Oncol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To explore the safety and role of tegafur\/gimeracil\/oteracil (S1) maintenance therapy (MT) in metastatic nasopharyngeal carcinoma (NPC) patients after response to first-line chemotherapy and to assess outcome-associated biomarkers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a multicentre, open-label, randomized controlled study involving metastatic NPC patients recruited (from May 2015 to May 2019) at five hospitals in China. The participants were randomized to S1-MT (receiving S1 MT until disease progression or intolerance) or non-MT (followed up until disease progression) groups. The primary endpoint was the progression-free survival (PFS). The secondary endpoints were the overall survival (OS), the correlation between EBV-DNA, serum amyloid A (SAA) status, and outcomes after the first-line chemotherapy, and safety.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The median follow-up was 24.3\u00a0months; 88 and 95 participants were evaluable in the S1-MT and non-MT groups, respectively. Compared with non-MT, S1-MT prolonged PFS (16.9 vs. 9.3\u00a0months, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and OS (33.6 vs. 20.6\u00a0months, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Regardless of their EBV-DNA status after first-line chemotherapy, participants were able to benefit from S1 MT, but EBV-DNA-positive participants benefited more significantly (PFS: HR\u2009=\u20090.600, 95% CI\u2009=\u20090.373\u20130.965, <jats:italic>P<\/jats:italic>\u2009=\u20090.035; OS: HR\u2009=\u20090.393, 95% CI\u2009=\u20090.227\u20130.681, <jats:italic>P<\/jats:italic>\u2009=\u20090.001). MT only improved PFS and OS in patients with an SAA decline after first-line chemotherapy (PFS: HR\u2009=\u20090.570, 95% CI\u2009=\u20090.350\u20130.919, <jats:italic>P<\/jats:italic>\u2009=\u20090.021; OS: HR\u2009=\u20090.404, 95% CI\u2009=\u20090.230\u20130.709, <jats:italic>P<\/jats:italic>\u2009=\u20090.002). The median S1 treatment was 23 cycles. Grade 1\u20132 skin pigmentation, oral mucositis, and hand and foot syndrome were the main adverse reactions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>For metastatic NPC patients with first-line chemotherapy response, S1 MT can improve PFS and OS, with good tolerability. EBV-DNA and SAA can better help us identify patients who can benefit from MT after standard treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>The study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR-IOR-16007939).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00432-022-04341-2","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T16:22:04Z","timestamp":1662654124000},"page":"4327-4338","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Maintenance therapy improves the survival outcomes of patients with metastatic nasopharyngeal carcinoma responding to first-line chemotherapy: a multicentre, randomized controlled clinical study"],"prefix":"10.1007","volume":"149","clinical-trial-number":[{"clinical-trial-number":"chictr-ior-16007939","registry":"10.18810\/chictr"}],"author":[{"given":"Ying","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohua","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meilian","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjie","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianbin","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xishan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"key":"4341_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13092236","author":"ME Cazzaniga","year":"2021","unstructured":"Cazzaniga ME, Cordani N, Capici S, Cogliati V, Riva F, Cerrito MG (2021) Metronomic chemotherapy. 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