Meta-analysis of efficacy and safety of induction chemotherapy combined with radiotherapy±concurrent chemotherapy for nasopharyngeal carcinoma patients in the era of intensity-modulated radiation therapy
Yang Jie1,2, Liang Zhongguo1, Jiang Yuting1, Chen Kaihua1, Li Ling1, Qu Song1, Zhu Xiaodong1,2
1Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning 530021, China; 2Department of Oncology, Affiliated Wuming Hospital of Guangxi Medical University, Nanning 530199, China
Abstract：Objective To compare the efficacy and adverse events of induction chemotherapy combined with radiotherapy alone (IC+RT) and induction chemotherapy combined with concurrent chemoradiotherapy (IC+CCRT) for nasopharyngeal carcinoma in the era of intensity-modulated radiation therapy in this Meta-analysis. Methods Retrospective or randomized controlled clinical studies published between 2010 and 2020 were searched from the Cochrane Library, PubMed, and Web of Science databases. The selected studies included nasopharyngeal carcinoma patients treated with IC+ CCRT or IC+ RT. STATA 12software was used to combine the hazard ratio (HR), risk ratio (RR) and 95% confidence interval (CI), and random or fixed effect models were used for statistical analysis. Results A total of 2483 patients from eight retrospective studies were included. The overall survival in the IC+CCRT group was similar to that in the IC+RT group (HR=0.78, 95%CI:0.58-1.04, P=0.091). However, the distant metastasis-free survival (HR=0.56, 95%CI:0.42-0.74, P<0.001) and progression-free survival (HR=0.65, 95%CI:0.54-0.77, P<0.001) were improved in the IC+CCRT group compared with those in the IC+RT group. In terms of adverse reactions, the acute adverse reactions in the IC+CCRT group were increased significantly compared with those in the IC+RT group. Conclusions In the treatment of nasopharyngeal carcinoma, the overall survival of two treatment modes is similar, but the distant metastasis-free survival and progression-free survival in the IC+CCRT group are better than those in the IC+RT group, whereas the incidence of adverse reactions is also increased. IC+CCRT may be a recommended treatment for nasopharyngeal carcinoma patients, but more research is needed.
Yang Jie,Liang Zhongguo,Jiang Yuting et al. Meta-analysis of efficacy and safety of induction chemotherapy combined with radiotherapy±concurrent chemotherapy for nasopharyngeal carcinoma patients in the era of intensity-modulated radiation therapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(3): 229-235.
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