Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic Review

Background: Tegafur–uracil (UFT), an oral fluoropyrimidine developed in Asia, has been investigated as a maintenance or adjuvant therapy in various malignancies. Its use in head and neck cancers, however, remains limited to small retrospective studies, primarily from East Asia. Given the need for co...

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Main Authors: Hsu-Lin Lee, Po-Huang Chen, Tzu-Chuan Huang, Ren-Hua Ye, Yueng-Hsiang Chu, Jih-Chin Lee, Hong-Jie Jhou, Jia-Hong Chen
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/5/286
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author Hsu-Lin Lee
Po-Huang Chen
Tzu-Chuan Huang
Ren-Hua Ye
Yueng-Hsiang Chu
Jih-Chin Lee
Hong-Jie Jhou
Jia-Hong Chen
author_facet Hsu-Lin Lee
Po-Huang Chen
Tzu-Chuan Huang
Ren-Hua Ye
Yueng-Hsiang Chu
Jih-Chin Lee
Hong-Jie Jhou
Jia-Hong Chen
author_sort Hsu-Lin Lee
collection DOAJ
description Background: Tegafur–uracil (UFT), an oral fluoropyrimidine developed in Asia, has been investigated as a maintenance or adjuvant therapy in various malignancies. Its use in head and neck cancers, however, remains limited to small retrospective studies, primarily from East Asia. Given the need for cost-effective maintenance strategies in resource-limited settings, we conducted an exploratory systematic review to evaluate the clinical utility of UFT in non-metastatic head and neck squamous cell carcinoma (HNSCC) and nasopharyngeal carcinoma (NPC). Methods: We systematically searched PubMed, EMBASE, and Cochrane Library from inception through 1 May 2025 for retrospective cohort studies evaluating UFT after definitive therapy in non-metastatic HNSCC or NPC. Study selection followed PRISMA guidelines. Given the heterogeneity of included studies, we performed a structured narrative synthesis using the SWiM (Synthesis Without Meta-analysis) framework to summarize survival outcomes, treatment settings, and clinical contexts. Results: Seven retrospective studies (four HNSCC, three NPC) involving 508 patients were included. UFT was generally administered at 300–400 mg/day for 6–12 months. Across studies, UFT use was associated with favorable disease-free and overall survival trends in high-risk subgroups, including patients with extranodal extension and persistent EBV DNA. Treatment adherence and toxicity profiles were acceptable. Conclusions: While the evidence remains limited and heterogeneous, this review highlights recurring signals of benefit associated with UFT maintenance therapy in selected high-risk patients. Prospective trials are warranted to confirm these findings and better define a possible role of UFT in maintenance therapy in some advanced non-metastatic HNSCC and NPC.
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spelling doaj-art-18f04fed89f34c74a8aa382f6de7ef8d2025-08-20T01:56:27ZengMDPI AGCurrent Oncology1198-00521718-77292025-05-0132528610.3390/curroncol32050286Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic ReviewHsu-Lin Lee0Po-Huang Chen1Tzu-Chuan Huang2Ren-Hua Ye3Yueng-Hsiang Chu4Jih-Chin Lee5Hong-Jie Jhou6Jia-Hong Chen7Division of Hematology and Oncology, Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 411228, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, TaiwanDepartment of Otolaryngology–Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, TaiwanDepartment of Otolaryngology–Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, TaiwanDepartment of Neurology, Changhua Christian Hospital, Changhua 500011, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, TaiwanBackground: Tegafur–uracil (UFT), an oral fluoropyrimidine developed in Asia, has been investigated as a maintenance or adjuvant therapy in various malignancies. Its use in head and neck cancers, however, remains limited to small retrospective studies, primarily from East Asia. Given the need for cost-effective maintenance strategies in resource-limited settings, we conducted an exploratory systematic review to evaluate the clinical utility of UFT in non-metastatic head and neck squamous cell carcinoma (HNSCC) and nasopharyngeal carcinoma (NPC). Methods: We systematically searched PubMed, EMBASE, and Cochrane Library from inception through 1 May 2025 for retrospective cohort studies evaluating UFT after definitive therapy in non-metastatic HNSCC or NPC. Study selection followed PRISMA guidelines. Given the heterogeneity of included studies, we performed a structured narrative synthesis using the SWiM (Synthesis Without Meta-analysis) framework to summarize survival outcomes, treatment settings, and clinical contexts. Results: Seven retrospective studies (four HNSCC, three NPC) involving 508 patients were included. UFT was generally administered at 300–400 mg/day for 6–12 months. Across studies, UFT use was associated with favorable disease-free and overall survival trends in high-risk subgroups, including patients with extranodal extension and persistent EBV DNA. Treatment adherence and toxicity profiles were acceptable. Conclusions: While the evidence remains limited and heterogeneous, this review highlights recurring signals of benefit associated with UFT maintenance therapy in selected high-risk patients. Prospective trials are warranted to confirm these findings and better define a possible role of UFT in maintenance therapy in some advanced non-metastatic HNSCC and NPC.https://www.mdpi.com/1718-7729/32/5/286tegafur–uracilmaintenance therapyhead and neck squamous cell carcinomanasopharyngeal carcinoma
spellingShingle Hsu-Lin Lee
Po-Huang Chen
Tzu-Chuan Huang
Ren-Hua Ye
Yueng-Hsiang Chu
Jih-Chin Lee
Hong-Jie Jhou
Jia-Hong Chen
Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic Review
Current Oncology
tegafur–uracil
maintenance therapy
head and neck squamous cell carcinoma
nasopharyngeal carcinoma
title Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic Review
title_full Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic Review
title_fullStr Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic Review
title_full_unstemmed Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic Review
title_short Tegafur–Uracil Maintenance Therapy in Non-Metastatic Head and Neck Cancer: An Exploratory Systematic Review
title_sort tegafur uracil maintenance therapy in non metastatic head and neck cancer an exploratory systematic review
topic tegafur–uracil
maintenance therapy
head and neck squamous cell carcinoma
nasopharyngeal carcinoma
url https://www.mdpi.com/1718-7729/32/5/286
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