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Background <p>This study investigated the impact of SARS-CoV-2 infection on treatment-related adverse events (TRAEs) and 2-year survival outcomes in patients with newly diagnosed non-metastatic nasopharyngeal carcinoma (NPC) treated with radiotherapy alone or in combination with chemotherapy.</p> Methods <p>In this retrospective cohort study, 1,108 NPC patients diagnosed between May 2020 and March 2023 were included. Patients were categorized into a SARS-CoV-2-infected group (infection during chemotherapy or during/within 2&#xa0;weeks after radiotherapy) and an uninfected group. Propensity score matching was performed to minimize selection bias. Primary endpoints were acute and late TRAEs; secondary endpoints included 2-year overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRRFS).</p> Results <p>After matching, 211 pairs were analyzed. The 2-year OS (96.2% vs. 97.6%; <i>P</i> = 0.403), PFS (88.6% vs. 90.5%; <i>P</i> = 0.558), DMFS (92.4% vs. 91.5%; <i>P</i> = 0.720), and LRRFS (92.4% vs. 96.2%; <i>P</i> = 0.099) were similar between groups. However, SARS-CoV-2-infected patients had higher rates of leukopenia during induction chemotherapy (39.8% vs. 28.9%; <i>P</i> = 0.044) and hepatic impairment during both induction chemotherapy (49.3% vs. 36.0%; <i>P</i> = 0.044) and radiotherapy (26.9% vs. 12.2%; <i>P</i> = 0.001).&#xa0;Cox regression confirmed that SARS-CoV-2 infection was not an independent predictor of survival outcomes.</p> Conclusions <p>SARS-CoV-2 infection during anticancer therapy in non-metastatic NPC patients was associated with increased hematologic and hepatic toxicities but did not adversely affect 2-year survival outcomes.</p>

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SARS-CoV-2 infection and its effects on toxicity and survival in non-metastatic nasopharyngeal carcinoma: a matched cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月22日

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  • Xiaoping Lin,
  • Fei Mo,
  • Bin Zhang,
  • Yufei Pan,
  • Jinxuan Dai,
  • Shufang Liao,
  • Yunyan Mo,
  • Xiangyun Kong,
  • Wei Jiang

摘要

Background

This study investigated the impact of SARS-CoV-2 infection on treatment-related adverse events (TRAEs) and 2-year survival outcomes in patients with newly diagnosed non-metastatic nasopharyngeal carcinoma (NPC) treated with radiotherapy alone or in combination with chemotherapy.

Methods

In this retrospective cohort study, 1,108 NPC patients diagnosed between May 2020 and March 2023 were included. Patients were categorized into a SARS-CoV-2-infected group (infection during chemotherapy or during/within 2 weeks after radiotherapy) and an uninfected group. Propensity score matching was performed to minimize selection bias. Primary endpoints were acute and late TRAEs; secondary endpoints included 2-year overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRRFS).

Results

After matching, 211 pairs were analyzed. The 2-year OS (96.2% vs. 97.6%; P = 0.403), PFS (88.6% vs. 90.5%; P = 0.558), DMFS (92.4% vs. 91.5%; P = 0.720), and LRRFS (92.4% vs. 96.2%; P = 0.099) were similar between groups. However, SARS-CoV-2-infected patients had higher rates of leukopenia during induction chemotherapy (39.8% vs. 28.9%; P = 0.044) and hepatic impairment during both induction chemotherapy (49.3% vs. 36.0%; P = 0.044) and radiotherapy (26.9% vs. 12.2%; P = 0.001). Cox regression confirmed that SARS-CoV-2 infection was not an independent predictor of survival outcomes.

Conclusions

SARS-CoV-2 infection during anticancer therapy in non-metastatic NPC patients was associated with increased hematologic and hepatic toxicities but did not adversely affect 2-year survival outcomes.