{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:30:28Z","timestamp":1786678228491,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>De novo metastatic nasopharyngeal carcinoma (NPC) has a poor prognosis despite modern chemotherapy. Gemcitabine\u2010cisplatin is the standard chemotherapy backbone, whereas carboplatin is commonly used as a cisplatin alternative for its better tolerability. This study evaluated high\u2010dose locoregional radiotherapy (LRRT) after standardized gemcitabine\u2010platinum chemotherapy and identified prognostic factors for patient selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients with de novo metastatic NPC treated at two Hong Kong tertiary centers (2014\u20132024) with first\u2010line gemcitabine\u2013platinum chemotherapy followed by high\u2010dose LRRT (\u226560\u00a0Gy). Baseline characteristics, treatment details, toxicities, and outcomes were collected. Progression\u2010free survival (PFS) and overall survival (OS) were estimated using the Kaplan\u2013Meier method, and prognostic factors were evaluated with log\u2010rank tests and multivariable Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010six patients were included (median age 58\u00a0years; 83.3% male). At diagnosis, 27.3% had liver metastases and 83.8% had &gt;1 metastatic lesion. Most (81.8%) completed six chemotherapy cycles (56.1% gemcitabine\u2013cisplatin; 42.4% gemcitabine\u2013carboplatin). LRRT completion rate was 93.9%. The rates of grade\u00a03 dermatitis and mucositis were 18.2% and 7.6%. Two treatment\u2010related deaths were recorded. At a median follow\u2010up of 42\u00a0months, median PFS and OS were 6.8 and 22.3\u00a0months, respectively; distant progression was the predominant failure pattern (71.2%). On multivariable analysis, liver metastasis and gemcitabine\u2013carboplatin use independently predicted poorer PFS, while gemcitabine\u2013carboplatin and &gt;1 metastatic lesion portended poorer OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High\u2010dose LRRT after gemcitabine\u2013platinum was feasible with acceptable toxicity but yielded modest PFS in an unselected population of de novo metastatic NPC, with outcomes strongly influenced by metastatic burden, liver involvement, and platinum choice. Gemcitabine\u2013cisplatin remains the preferred chemotherapy backbone, and LRRT may be best reserved for carefully selected patients in the contemporary chemo\u2010immunotherapy era.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajco.70159","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:12:39Z","timestamp":1786677159000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Consolidative Radiotherapy After Gemcitabine\u2010Platinum Chemotherapy in De Novo Metastatic Nasopharyngeal Carcinoma: Impact of Chemotherapy Backbone and Prognostic Factors on Survival"],"prefix":"10.1111","author":[{"given":"Joyce L. Y.","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Oncology United Christian Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C. H.","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology Queen Elizabeth Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(19)30956\u20100"},{"issue":"9","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1007\/s11864-023-01101-3","article-title":"Recurrent\/Metastatic Nasopharyngeal Carcinoma Treatment From Present to Future: Where Are We and Where Are We Heading?","volume":"24","author":"Juarez\u2010Vignon Whaley J. 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