PMID- 32700235
OWN - NLM
STAT- MEDLINE
DCOM- 20210423
LR  - 20220531
IS  - 1434-4726 (Electronic)
IS  - 0937-4477 (Linking)
VI  - 278
IP  - 5
DP  - 2021 May
TI  - The evaluation of adding induction chemotherapy to concurrent chemoradiotherapy 
      for locally advanced nasopharyngeal carcinoma: a meta-analysis.
PG  - 1545-1558
LID - 10.1007/s00405-020-06218-x [doi]
AB  - PURPOSE: We performed a meta-analysis to compare the efficacy and safety of 
      induction chemotherapy (IC) followed by cisplatin-based concurrent 
      chemoradiotherapy (CCRT) versus cisplatin-based CCRT for patients with locally 
      advanced nasopharyngeal carcinoma (LA-NPC). METHODS: We systematically searched 
      PubMed, the Cochrane Library and Embase until February 29, 2020, for eligible 
      randomized controlled trials (RCTs). The quality of the studies was assessed with 
      the Cochrane Collaboration risk of bias tool. The following outcomes of interest 
      were analyzed: 1) progression-free survival (PFS); 2) overall survival (OS); 3) 
      distant metastasis-free survival (DMFS); 4) locoregional failure-free survival 
      (LRFFS); and 5) any grade 3 or 4 treatment-related adverse events (AEs). The data 
      were pooled with the use of hazard ratios (HRs) or odds ratios (ORs). Subgroup, 
      heterogeneity and sensitivity analyses were performed. RESULTS: After screening 
      all studies selected from the initial search, seven trials with 2233 patients met 
      the inclusion criteria. Compared to cisplatin-based CCRT alone, there was 
      reliable evidence that IC significantly improved PFS (HR 0.65, 95% CI 0.55-0.75, 
      P < 0.00001), OS (HR 0.61, 95% CI 0.45-0.83, P = 0.002), DMFS (HR 0.65, 95% CI 
      0.53-0.79, P < 0.0001) and LRFFS (HR 0.68, 95% CI 0.53-0.88, P = 0.003) and was 
      associated with a markedly increased risk of AEs (grade 3/4) during the IC and 
      CCRT phases. No significant difference in the incidence of late AEs (grade 3/4) 
      was observed between different arms. CONCLUSION: Compared to cisplatin-based CCRT 
      alone, IC followed by cisplatin-based CCRT confers real and substantial favorable 
      survival outcomes with controllable toxicities. Therefore, it is reasonable to 
      define IC followed by cisplatin-based CCRT as one of the standard treatment 
      strategies for patients with LA-NPC.
FAU - Tang, Min
AU  - Tang M
AUID- ORCID: 0000-0003-0144-5936
AD  - Department of Oncology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, 400016, People's Republic of China.
FAU - Jia, Zhongxiong
AU  - Jia Z
AD  - Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, 400016, People's Republic of China.
FAU - Zhang, Ju
AU  - Zhang J
AD  - Department of Oncology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, 400016, People's Republic of China. Zhangjucq@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20200722
PL  - Germany
TA  - Eur Arch Otorhinolaryngol
JT  - European archives of oto-rhino-laryngology : official journal of the European 
      Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the 
      German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
JID - 9002937
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols
MH  - *Carcinoma/therapy
MH  - Chemoradiotherapy
MH  - Humans
MH  - Induction Chemotherapy
MH  - Nasopharyngeal Carcinoma/drug therapy
MH  - *Nasopharyngeal Neoplasms/drug therapy
OTO - NOTNLM
OT  - Chemoradiotherapy
OT  - Induction chemotherapy
OT  - Meta-analysis
OT  - Nasopharyngeal carcinoma
OT  - Randomized controlled trials
EDAT- 2020/07/24 06:00
MHDA- 2021/04/24 06:00
CRDT- 2020/07/24 06:00
PHST- 2020/05/02 00:00 [received]
PHST- 2020/07/15 00:00 [accepted]
PHST- 2020/07/24 06:00 [pubmed]
PHST- 2021/04/24 06:00 [medline]
PHST- 2020/07/24 06:00 [entrez]
AID - 10.1007/s00405-020-06218-x [pii]
AID - 10.1007/s00405-020-06218-x [doi]
PST - ppublish
SO  - Eur Arch Otorhinolaryngol. 2021 May;278(5):1545-1558. doi: 
      10.1007/s00405-020-06218-x. Epub 2020 Jul 22.