Shan-Shan Yang1, Jian-Gui Guo2, Jia-Ni Liu3, Zhi-Qiao Liu1, En-Ni Chen1, Chun-Yan Chen1, Pu-Yun OuYang1, Fei Han1, Fang-Yun Xie1. 1. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China. 2. Department of Radiation Oncology, The First People's Hospital of Foshan, Foshan, China. 3. Department of Head and Neck Oncology, The Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Abstract
BACKGROUND: Previous meta-analysis had evaluated the effect of induction chemotherapy in nasopharyngeal carcinoma. But two trials with opposite findings were not included and the long-term result of another trial significantly differed from the preliminary report. This updated meta-analysis was thus warranted. METHODS: Literature search was conducted to identify randomized controlled trials focusing on the additional efficacy of induction chemotherapy in nasopharyngeal carcinoma. Trial-level pooled analysis of hazard ratio (HR) for progression free survival and overall survival and risk ratio (RR) for locoregional control rate and distant control rate were performed. RESULTS: Twelve trials were eligible. The addition of induction chemotherapy significantly prolonged both progression free survival (HR=0.68, 95% confidence interval [CI] 0.60-0.76, p<0.001) and overall survival (HR=0.67, 95% CI 0.54-0.80, p<0.001), with 5-year absolute benefit of 11.31% and 8.95%, respectively. Locoregional (RR=0.80, 95% CI 0.70-0.92, p=0.002) and distant control (RR=0.70, 95% CI 0.62-0.80) rates were significantly improved as well. The incidence of grade 3-4 adverse events during the concurrent chemoradiotherapy was higher in leukopenia (p=0.028), thrombocytopenia (p<0.001), and fatigue (p=0.038) in the induction chemotherapy group. CONCLUSIONS: This meta-analysis supported that induction chemotherapy could benefit patients with nasopharyngeal carcinoma in progression free survival, overall survival, locoregional, and distant control rate.
BACKGROUND: Previous meta-analysis had evaluated the effect of induction chemotherapy in nasopharyngeal carcinoma. But two trials with opposite findings were not included and the long-term result of another trial significantly differed from the preliminary report. This updated meta-analysis was thus warranted. METHODS: Literature search was conducted to identify randomized controlled trials focusing on the additional efficacy of induction chemotherapy in nasopharyngeal carcinoma. Trial-level pooled analysis of hazard ratio (HR) for progression free survival and overall survival and risk ratio (RR) for locoregional control rate and distant control rate were performed. RESULTS: Twelve trials were eligible. The addition of induction chemotherapy significantly prolonged both progression free survival (HR=0.68, 95% confidence interval [CI] 0.60-0.76, p<0.001) and overall survival (HR=0.67, 95% CI 0.54-0.80, p<0.001), with 5-year absolute benefit of 11.31% and 8.95%, respectively. Locoregional (RR=0.80, 95% CI 0.70-0.92, p=0.002) and distant control (RR=0.70, 95% CI 0.62-0.80) rates were significantly improved as well. The incidence of grade 3-4 adverse events during the concurrent chemoradiotherapy was higher in leukopenia (p=0.028), thrombocytopenia (p<0.001), and fatigue (p=0.038) in the induction chemotherapy group. CONCLUSIONS: This meta-analysis supported that induction chemotherapy could benefit patients with nasopharyngeal carcinoma in progression free survival, overall survival, locoregional, and distant control rate.
Authors: D T Chua; J S Sham; D Choy; V Lorvidhaya; Y Sumitsawan; S Thongprasert; V Vootiprux; A Cheirsilpa; T Azhar; A H Reksodiputro Journal: Cancer Date: 1998-12-01 Impact factor: 6.860
Authors: Pierre Blanchard; Anne Lee; Sophie Marguet; Julie Leclercq; Wai Tong Ng; Jun Ma; Anthony T C Chan; Pei-Yu Huang; Ellen Benhamou; Guopei Zhu; Daniel T T Chua; Yong Chen; Hai-Qiang Mai; Dora L W Kwong; Shie Lee Cheah; James Moon; Yuk Tung; Kwan-Hwa Chi; George Fountzilas; Li Zhang; Edwin Pun Hui; Tai-Xiang Lu; Jean Bourhis; Jean Pierre Pignon Journal: Lancet Oncol Date: 2015-05-06 Impact factor: 41.316