Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials
PurposeInduction chemotherapy followed by concurrent chemoradiotherapy (IC-CCRT) may be beneficial for nasopharyngeal carcinoma. However, the evidence on medium- and long-term effects of IC-CCRT is limited, and new randomized controlled trials (RCTs) have been published after 2018. Therefore, this s...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.965719/full |
| _version_ | 1798001028746969088 |
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| author | Ting-Chieh Huang Chi-Jen Chen Chi-Jen Chen Yi-Fang Ding Yi-No Kang Yi-No Kang Yi-No Kang Yi-No Kang |
| author_facet | Ting-Chieh Huang Chi-Jen Chen Chi-Jen Chen Yi-Fang Ding Yi-No Kang Yi-No Kang Yi-No Kang Yi-No Kang |
| author_sort | Ting-Chieh Huang |
| collection | DOAJ |
| description | PurposeInduction chemotherapy followed by concurrent chemoradiotherapy (IC-CCRT) may be beneficial for nasopharyngeal carcinoma. However, the evidence on medium- and long-term effects of IC-CCRT is limited, and new randomized controlled trials (RCTs) have been published after 2018. Therefore, this systematic review and meta-analysis compared survival rates between patients with nasopharyngeal carcinoma receiving IC-CCRT or concurrent chemoradiotherapy (CCRT).MethodsFour databases were searched for RCTs on this topic. Two authors independently selected studies, assessed evidence, and extracted data on progression-free survival, overall survival, metastasis-free survival, and local recurrence-free survival. Available data were pooled in a random-effects model and mainly presented in hazard ratio (HR). Heterogeneity and small study effects were also evaluated.ResultsEleven RCTs (n = 3345) were deemed eligible. Pooled results revealed that patients receiving IC-CCRT had significantly improved progression-free survival (HR = 0.66, P < 0.05), overall survival (HR = 0.64, P < 0.05), metastasis-free survival (HR = 0.58, P < 0.05), and local recurrence-free survival (HR = 0.69, P < 0.05) at 3 years, but no significant difference in 5-year overall survival was noted between IC-CCRT and CCRT (HR = 0.84, P > 0.05). Most findings had low heterogeneity.ConclusionIC-CCRT may benefit patients with nasopharyngeal carcinoma in the medium term, although no significant difference was observed in 5-year survival compared with CCRT. All outcomes had decreased survival rate from the 3-years to 5-year follow-up. Differences in patient ethnicities and regimens of IC-CCRT may be sources of heterogeneity. |
| first_indexed | 2024-04-11T11:29:33Z |
| format | Article |
| id | doaj.art-8e0e2209e49c4481a0e00dd918b0e3ea |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T11:29:33Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-8e0e2209e49c4481a0e00dd918b0e3ea2022-12-22T04:26:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.965719965719Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trialsTing-Chieh Huang0Chi-Jen Chen1Chi-Jen Chen2Yi-Fang Ding3Yi-No Kang4Yi-No Kang5Yi-No Kang6Yi-No Kang7Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanDepartment of Otolaryngology Head and Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, TaiwanDepartment of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanEvidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanResearch Center of Big Data and Meta-analysis Center, Wan Fang Hospital, Taipei Medical University, Taipei, TaiwanCochrane Taiwan, Taipei Medical University, Taipei, TaiwanInstitute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, TaiwanPurposeInduction chemotherapy followed by concurrent chemoradiotherapy (IC-CCRT) may be beneficial for nasopharyngeal carcinoma. However, the evidence on medium- and long-term effects of IC-CCRT is limited, and new randomized controlled trials (RCTs) have been published after 2018. Therefore, this systematic review and meta-analysis compared survival rates between patients with nasopharyngeal carcinoma receiving IC-CCRT or concurrent chemoradiotherapy (CCRT).MethodsFour databases were searched for RCTs on this topic. Two authors independently selected studies, assessed evidence, and extracted data on progression-free survival, overall survival, metastasis-free survival, and local recurrence-free survival. Available data were pooled in a random-effects model and mainly presented in hazard ratio (HR). Heterogeneity and small study effects were also evaluated.ResultsEleven RCTs (n = 3345) were deemed eligible. Pooled results revealed that patients receiving IC-CCRT had significantly improved progression-free survival (HR = 0.66, P < 0.05), overall survival (HR = 0.64, P < 0.05), metastasis-free survival (HR = 0.58, P < 0.05), and local recurrence-free survival (HR = 0.69, P < 0.05) at 3 years, but no significant difference in 5-year overall survival was noted between IC-CCRT and CCRT (HR = 0.84, P > 0.05). Most findings had low heterogeneity.ConclusionIC-CCRT may benefit patients with nasopharyngeal carcinoma in the medium term, although no significant difference was observed in 5-year survival compared with CCRT. All outcomes had decreased survival rate from the 3-years to 5-year follow-up. Differences in patient ethnicities and regimens of IC-CCRT may be sources of heterogeneity.https://www.frontiersin.org/articles/10.3389/fonc.2022.965719/fullneoadjuvant chemotherapyconcurrent chemoradiotherapynasopharynx cancerinduction chemotherapynasopharyngeal cancer |
| spellingShingle | Ting-Chieh Huang Chi-Jen Chen Chi-Jen Chen Yi-Fang Ding Yi-No Kang Yi-No Kang Yi-No Kang Yi-No Kang Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials Frontiers in Oncology neoadjuvant chemotherapy concurrent chemoradiotherapy nasopharynx cancer induction chemotherapy nasopharyngeal cancer |
| title | Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials |
| title_full | Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials |
| title_fullStr | Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials |
| title_full_unstemmed | Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials |
| title_short | Impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma: A meta-analysis of randomized controlled trials |
| title_sort | impact of induction chemotherapy with concurrent chemoradiotherapy on nasopharyngeal carcinoma a meta analysis of randomized controlled trials |
| topic | neoadjuvant chemotherapy concurrent chemoradiotherapy nasopharynx cancer induction chemotherapy nasopharyngeal cancer |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.965719/full |
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