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Purpose: Induction chemotherapy plus concurrent chemoradiotherapy and concurrent chemoradiotherapy alone are both standard treatment regimens for managing locally advanced nasopharyngeal carcinoma. However, the results of comparisons between them in clinical trials vary. Therefore, we designed this meta-analysis to illustrate their advantages and disadvantages in patients with locally advanced nasopharyngeal carcinoma. Methods: We thoroughly searched the PubMed, EMBASE, and Cochrane Library databases and then merged the effect indicators of hazard ratios and risk ratios using RevMan 5.1. Results: Seven randomized controlled trials totaling 2,319 patients were included in our research. The synthesized results showed that induction chemotherapy plus concurrent chemoradiotherapy improved overall survival (HR = 0.75, 95% CI: 0.63-0.89, P = 0.001), progression-free survival (HR = 0.69, 95% CI: 0.60-0.80, P < 0.001), distant metastasis-free survival (HR = 0.65, 95% CI: 0.53-0.80, P < 0.001) and locoregional recurrence-free survival (HR = 0.68 95%, CI: 0.54-0.86, P = 0.001) versus concurrent chemoradiotherapy alone. It also increased the risk of anemia, thrombocytopenia, and neutropenia during concurrent chemoradiotherapy. However, the incidence of leukopenia and mucositis was similar in induction chemotherapy and induction chemotherapy plus concurrent chemoradiotherapy. Furthermore, the subgroup analysis showed better survival outcomes with induction chemotherapy plus concurrent chemoradiotherapy than with concurrent chemoradiotherapy alone in the triweekly cisplatin subgroup (all P < 0.01), whereas induction chemotherapy plus concurrent chemoradiotherapy could only improve progression-free survival and locoregional recurrence-free survival in the weekly cisplatin subgroup (HR = 0.78, P = 0.02; and HR = 0.66, P = 0.03, respectively). Conclusions: Induction chemotherapy plus concurrent chemoradiotherapy improved survival outcomes in patients with locally advanced nasopharyngeal carcinoma versus concurrent chemoradiotherapy. For the weekly cisplatin regimen subgroup, it did not improve remote control or overall survival versus concurrent chemoradiotherapy alone, warranting further clarification.

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ObjectiveThis meta-analysis explored whether the expression of actin filament-associated protein 1 antisense RNA 1 (AFAP1-AS1) is related to the prognosis and clinicopathological features of patients with cancer.MethodsPubMed, EMBASE, and Cochrane Library were systematically searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the prognostic value based on overall survival(OS), disease-free survival (DFS), and progression-free survival (PFS). Odds ratios (ORs) with 95% CIs were used to determine the relationships between AFAP1-AS1 and clinicopathological features, such as large tumor size (LTS), high tumor stage (HTS), poor histological grade (PHG), lymph node metastasis(LNM), and distant metastasis (DM).ResultsThirty-five eligible articles and 3433 cases were analyzed. High AFAP1-AS1 expression, compared to low AFAP1-AS1 expression, correlated with significantly shorter OS (HR = 2.15, 95% CI =1.97–2.34, P < 0.001), DFS (HR = 1.37, 95% CI = 1.19–1.57, P < 0.001), and PFS (HR = 1.97, 95% CI= 1.56–2.50, P < 0.001) in patients with cancer. In various cancers, elevated AFAP1-AS1 expression was significantly associated with LTS (OR = 2.76, 95% CI = 2.16–3.53, P < 0.001), HTS (OR = 2.23, 95% CI =1.83–2.71, P < 0.001), and PHG (OR = 1.39, 95% CI = 1.08–1.79, P = 0.01) but not LNM (OR = 1.59, 95%CI = 0.88–2.85, P = 0.12) or DM (OR = 1.81, 95% CI = 0.90–3.66, P = 0.10).ConclusionHigh AFAP1-AS1 expression was associated with prognostic and clinicopathological features, suggesting that AFAP1-AS1 is a prognostic biomarker for human cancers.