PMID- 34259896
OWN - NLM
STAT- MEDLINE
DCOM- 20220308
LR  - 20221207
IS  - 1434-4726 (Electronic)
IS  - 0937-4477 (Linking)
VI  - 279
IP  - 3
DP  - 2022 Mar
TI  - The safety and efficacy of gemcitabine and cisplatin (GP)-based induction 
      chemotherapy plus concurrent chemoradiotherapy in locoregionally advanced 
      nasopharyngeal carcinoma: a meta-analysis.
PG  - 1561-1572
LID - 10.1007/s00405-021-06940-0 [doi]
AB  - OBJECTIVE: To assess the safety and efficacy of gemcitabine and cisplatin 
      (GP)-based induction chemotherapy (IC) plus concurrent chemoradiotherapy (CCRT) 
      for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC). 
      METHODS: We systematically searched the PubMed, Web of Science, Embase, and 
      Cochrane Library databases. The endpoints included overall survival (OS), 
      progression-free survival (PFS), distant failure-free survival (DMFS), 
      locoregional failure-free survival (LRFFS) and treatment-related adverse events 
      (AEs). RESULTS: A total of seven studies were included in this meta-analysis. 
      When GP-based IC was compared with double-drug-based or triple-drug-based IC, 
      there were no significant differences in OS (HR 0.64, P = 0.08), PFS (HR 0.71, 
      P = 0.09), DMFS (HR 0.87, P = 0.49) or LRFFS (HR 0.88, P = 0.66). Furthermore, 
      subgroup analysis revealed that GP IC led to an improvement in OS compared with 
      triple-drug-based IC (P < 0.0001). Regarding safety, compared to 
      triple-drug-based IC, GP-based IC was related to a decreased risk of leucopenia 
      (P = 0.007) and neutropenia (P = 0.02) but was associated with an increased risk 
      of thrombocytopenia (P = 0.01). Compared to double-drug-based IC, the prevalence 
      of grade 3 or above thrombocytopenia was higher in the GP group (P = 0.007). No 
      significant difference in the incidence of other AEs was observed. CONCLUSION: 
      Based on efficacy and safety, our meta-analysis demonstrated that, compared to 
      double-drug-based or triple-drug-based IC, IC with a GP regimen does not appear 
      to improve OS, PFS, DMFS or LRFFS and mainly led to an increased risk of grade3/4 
      thrombocytopenia. Notably, our subgroup analysis data show that GP-based IC may 
      bring improved trends in OS as compared to triple-drug-based IC. For the optimal 
      IC regimen has not been established, which IC regimen will benefit most LA-NPC 
      patients should be further explored.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Tang, Min
AU  - Tang M
AUID- ORCID: 0000-0003-0144-5936
AD  - Department of Oncology, The First Affiliated Hospital of Chongqing Medical 
      University, No.1 Youyi Road, Yu Zhong District, 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, No.1 Youyi Road, Yu Zhong District, 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, No.1 Youyi Road, Yu Zhong District, Chongqing, 400016, People's 
      Republic of China. Zhangjucq@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210714
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
RN  - 0W860991D6 (Deoxycytidine)
RN  - Q20Q21Q62J (Cisplatin)
RN  - 0 (Gemcitabine)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Chemoradiotherapy/adverse effects
MH  - *Cisplatin/therapeutic use
MH  - Deoxycytidine/analogs & derivatives
MH  - Humans
MH  - Induction Chemotherapy
MH  - Nasopharyngeal Carcinoma/drug therapy
MH  - *Nasopharyngeal Neoplasms
MH  - Gemcitabine
OTO - NOTNLM
OT  - Chemoradiotherapy
OT  - Cisplatin
OT  - Gemcitabine
OT  - Induction chemotherapy
OT  - Meta-analysis
OT  - Nasopharyngeal carcinoma
EDAT- 2021/07/15 06:00
MHDA- 2022/03/09 06:00
CRDT- 2021/07/14 12:27
PHST- 2021/01/13 00:00 [received]
PHST- 2021/06/11 00:00 [accepted]
PHST- 2021/07/15 06:00 [pubmed]
PHST- 2022/03/09 06:00 [medline]
PHST- 2021/07/14 12:27 [entrez]
AID - 10.1007/s00405-021-06940-0 [pii]
AID - 10.1007/s00405-021-06940-0 [doi]
PST - ppublish
SO  - Eur Arch Otorhinolaryngol. 2022 Mar;279(3):1561-1572. doi: 
      10.1007/s00405-021-06940-0. Epub 2021 Jul 14.