UFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy
Abstract Background Head and neck squamous cell carcinoma (HNSCC) presents significant therapeutic challenges, particularly in patients with advanced disease. Despite advancements in treatment, high recurrence rates and poor overall survival (OS) remain major concerns. This study evaluates the impac...
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BMC
2025-05-01
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| Series: | Cancer Cell International |
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| Online Access: | https://doi.org/10.1186/s12935-025-03807-w |
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| author | Jason Chia-Hsun Hsieh Ming-Yu Lien Pei-Hung Chang Hung-Ming Wang Kun-Yun Yeh Ching-Liang Ho Ching-Yun Hsieh Meng-Che Hsieh Jia-Hong Chen |
| author_facet | Jason Chia-Hsun Hsieh Ming-Yu Lien Pei-Hung Chang Hung-Ming Wang Kun-Yun Yeh Ching-Liang Ho Ching-Yun Hsieh Meng-Che Hsieh Jia-Hong Chen |
| author_sort | Jason Chia-Hsun Hsieh |
| collection | DOAJ |
| description | Abstract Background Head and neck squamous cell carcinoma (HNSCC) presents significant therapeutic challenges, particularly in patients with advanced disease. Despite advancements in treatment, high recurrence rates and poor overall survival (OS) remain major concerns. This study evaluates the impact of tegafur-uracil (UFUR) maintenance therapy on survival outcomes in patients with advanced HNSCC following definitive chemoradiotherapy. Methods A cohort of 424 advanced HNSCC patients treated with definitive chemoradiotherapy were analyzed, with a median follow-up of 25 months. Patients were stratified into UFUR (+) and UFUR (-) groups, with baseline characteristics balanced across both arms. Oncologic outcomes, including recurrence-free survival (RFS), OS, locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared between these groups. Results UFUR maintenance therapy significantly reduced recurrence rates (34% vs. 47%, p < 0.002), driven primarily by improving locoregional control (23% vs. 37%, p < 0.001). While distant metastasis rates were similar between groups, UFUR (+) patients demonstrated a markedly improved median OS (51.6 months vs. 24.3 months, p < 0.001). The UFUR (+) group also showed superior median LRFS (36.9 months vs. 20.2 months, p = 0.003) and DMFS (44.0 months vs. 23.5 months, p = 0.010). Subgroup analysis confirmed the benefits of UFUR maintenance across different stages of disease. Multivariate analysis identified UFUR maintenance, gender, and T stage as independent predictors of survival. Conclusion UFUR maintenance therapy significantly improves survival outcomes in patients with advanced HNSCC following definitive chemoradiotherapy, particularly through enhanced locoregional control, and should be considered a key component of personalized treatment strategies. |
| format | Article |
| id | doaj-art-91ad5b487e414ec8bad5a765d4f2ff61 |
| institution | OA Journals |
| issn | 1475-2867 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Cell International |
| spelling | doaj-art-91ad5b487e414ec8bad5a765d4f2ff612025-08-20T02:29:46ZengBMCCancer Cell International1475-28672025-05-012511810.1186/s12935-025-03807-wUFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapyJason Chia-Hsun Hsieh0Ming-Yu Lien1Pei-Hung Chang2Hung-Ming Wang3Kun-Yun Yeh4Ching-Liang Ho5Ching-Yun Hsieh6Meng-Che Hsieh7Jia-Hong Chen8College of Medicine, Chang Gung UniversityDivision of Hematology and Oncology, Department of Internal Medicine, China Medical University HospitalCollege of Medicine, Chang Gung UniversityCollege of Medicine, Chang Gung UniversityCollege of Medicine, Chang Gung UniversityDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterDivision of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital Department of Hematology-Oncology, E-Da Cancer HospitalDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterAbstract Background Head and neck squamous cell carcinoma (HNSCC) presents significant therapeutic challenges, particularly in patients with advanced disease. Despite advancements in treatment, high recurrence rates and poor overall survival (OS) remain major concerns. This study evaluates the impact of tegafur-uracil (UFUR) maintenance therapy on survival outcomes in patients with advanced HNSCC following definitive chemoradiotherapy. Methods A cohort of 424 advanced HNSCC patients treated with definitive chemoradiotherapy were analyzed, with a median follow-up of 25 months. Patients were stratified into UFUR (+) and UFUR (-) groups, with baseline characteristics balanced across both arms. Oncologic outcomes, including recurrence-free survival (RFS), OS, locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared between these groups. Results UFUR maintenance therapy significantly reduced recurrence rates (34% vs. 47%, p < 0.002), driven primarily by improving locoregional control (23% vs. 37%, p < 0.001). While distant metastasis rates were similar between groups, UFUR (+) patients demonstrated a markedly improved median OS (51.6 months vs. 24.3 months, p < 0.001). The UFUR (+) group also showed superior median LRFS (36.9 months vs. 20.2 months, p = 0.003) and DMFS (44.0 months vs. 23.5 months, p = 0.010). Subgroup analysis confirmed the benefits of UFUR maintenance across different stages of disease. Multivariate analysis identified UFUR maintenance, gender, and T stage as independent predictors of survival. Conclusion UFUR maintenance therapy significantly improves survival outcomes in patients with advanced HNSCC following definitive chemoradiotherapy, particularly through enhanced locoregional control, and should be considered a key component of personalized treatment strategies.https://doi.org/10.1186/s12935-025-03807-wUFURHNSCCMaintenance therapyRecurrence-free survivalOverall survival |
| spellingShingle | Jason Chia-Hsun Hsieh Ming-Yu Lien Pei-Hung Chang Hung-Ming Wang Kun-Yun Yeh Ching-Liang Ho Ching-Yun Hsieh Meng-Che Hsieh Jia-Hong Chen UFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy Cancer Cell International UFUR HNSCC Maintenance therapy Recurrence-free survival Overall survival |
| title | UFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy |
| title_full | UFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy |
| title_fullStr | UFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy |
| title_full_unstemmed | UFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy |
| title_short | UFUR maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy |
| title_sort | ufur maintenance therapy significantly improves survival in locally advanced head and neck squamous cell carcinoma following definitive chemoradiotherapy |
| topic | UFUR HNSCC Maintenance therapy Recurrence-free survival Overall survival |
| url | https://doi.org/10.1186/s12935-025-03807-w |
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