Metronomic Tegafur‐Uracil Maintenance Therapy in Oral Squamous Cell Carcinoma Following Adjuvant Chemoradiotherapy

OBJECTIVE: Oral cavity squamous cell carcinoma (OCSCC) is the predominant subtype of head and neck squamous cell carcinoma in Taiwan. Despite the guideline-recommended adjuvant chemoradiotherapy (CRT) for advanced pathological risk factors, long-term survival remains suboptimal. We evaluated the efficacy of tegafur-uracil as metronomic maintenance therapy following adjuvant CRT. METHODS: This single-center retrospective cohort study analyzed 197 OCSCC patients who underwent curative resection followed by adjuvant CRT. Patients were stratified by receipt of metronomic tegafur-uracil maintenance therapy. Survival outcomes were assessed using Cox proportional hazards regression and Kaplan-Meier analyses. RESULTS: Patients receiving metronomic maintenance therapy (49.2%, 97/197) demonstrated favorable survival trends compared with those who did not. Five-year disease-free survival and disease-specific survival rates were 57.4% vs. 53.0% (p = 0.101), and 70.1% versus 60.8% (p = 0.092), respectively. Patients with ≥ 2 risk factors-extreme body mass index, positive margins, extranodal extension, and advanced depth of invasion-demonstrated significantly better outcomes following metronomic maintenance therapy. Therapy initiation at 1-3 months post-CRT and a treatment duration exceeding 12 months were also associated with a better prognosis. CONCLUSION: Metronomic tegafur-uracil maintenance therapy was associated with favorable outcomes, particularly in patients presenting with ≥ 2 identified risk factors. Prospective multicenter validation is warranted.