A Bayesian network meta-analysis of the primary definitive therapies for locoregionally advanced nasopharyngeal carcinoma: IC+CCRT, CCRT+AC, and CCRT alone

Zhang, Zhanjie; Shi, Liangliang; Hong, Xiaohua; Xiao, Bo-Ya; Lin, Guo-He; Liu, Quentin; Wang, Bi-Cheng

doi:10.1371/journal.pone.0265551

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…The subsequent intergroup 0099 randomized trial confirmed that CCRT was better than radiotherapy alone for patients with locally advanced nasopharyngeal cancer (LA-NPC) [ 16 ]. Several meta-analyses have already shown that CCRT combined with or without AC could significantly improve OS [ 17 – 20 ]. Thus, CCRT has become the core therapy for patients with locally advanced nasopharyngeal cancer (LA-NPC).…”

Section: Discussionmentioning

confidence: 99%

Weekly versus triweekly cisplatin treatment in patients with locally advanced nasopharyngeal cancer during concurrent chemoradiotherapy

Li,

Sun

et al. 2023

Eur J Med Res

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Background For patients with locally advanced nasopharyngeal cancer (LA-NPC), concurrent chemoradiotherapy (CCRT) is the standardized treatment. However, whether a weekly or triweekly cisplatin regimen should be used during CCRT is controversial. Therefore, we conducted this meta-analysis to explore differences in the effects and toxicities of the two regimens. Methods We searched PubMed, Embase, and the Cochrane Library (until June 10, 2022). We evaluated overall survival (OS), distant metastasis-free survival (DMFS), locoregional recurrence–free survival (LRFS), disease-free survival (DFS) and grade ≥ 3 adverse events. The effect indices were hazard ratios (HRs) and odds ratios (ORs), and Review Manager software 5.4 (RevMan 5.4) was used for computations. Results We identified 7 studies in our analysis. There was no significant difference in OS (HR = 1.00, 95% CI 0.73–1.38, P = 0.99), DMFS (HR = 0.84, 95% CI 0.58–1.22, P = 0.36), LRFS (HR = 0.91, 95% CI 0.63–1.32, P = 0.62) or DFS (HR = 0.93, 95% CI 0.56–1.56; P = 0.78) between the weekly and triweekly cisplatin regimens. We found that the weekly cisplatin regimen was more likely to cause grade ≥ 3 hematological toxicity events than the triweekly cisplatin regimen. In addition, subgroup analyses revealed that patients undergoing CCRT and CCRT plus adjuvant chemotherapy (AC) had similar OS or DFS. Conclusion Weekly and triweekly cisplatin regimens had similar efficacy for LA-NPC. The triweekly regimen may replace the weekly regimen for LA-NPC because of lower toxicity. Larger data accumulation and more multicenter clinical trials may be needed to verify these results.

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Section: Discussionmentioning

confidence: 99%

Weekly versus triweekly cisplatin treatment in patients with locally advanced nasopharyngeal cancer during concurrent chemoradiotherapy

Li,

Sun

et al. 2023

Eur J Med Res

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“…RAS is reported to be associated with resistance to chemotherapy and radiotherapy ( Figure 3 ). It is widely accepted that chemotherapy and radiotherapy are important modalities of NPC therapy [ 95 , 96 , 97 ]. Although efficacy of salvage surgery for locally recurrent NPC is reported [ 98 ], indication for surgery is limited due to its anatomical features, so resistance to chemotherapy and radiotherapy leads directly to poor prognosis.…”

Section: Nasopharyngeal Carcinoma and Rasmentioning

confidence: 99%

Protein Farnesylation on Nasopharyngeal Carcinoma, Molecular Background and Its Potential as a Therapeutic Target

Kobayashi

Kondo

Dochi

et al. 2022

Cancers

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Nasopharyngeal carcinoma (NPC) is one of the Epstein–Barr virus (EBV)-associated malignancies. NPC is highly metastatic compared to other head and neck carcinomas, and evidence has shown that the metastatic features of NPC are involved in EBV infection. The prognosis of advanced cases, especially those with distant metastasis, is still poor despite advancements in molecular research and its application to clinical settings. Thus, further advancement in basic and clinical research that may lead to novel therapeutic modalities is needed. Farnesylation is a lipid modification in the C-terminus of proteins. It enables proteins to attach to the lipid bilayer structure of cellular membranes. Farnesylation was initially identified as a key process of membrane association and activation of the RAS oncoprotein. Farnesylation is thus expected to be an ideal therapeutic target in anti-RAS therapy. Additionally, more and more molecular evidence has been reported, showing that proteins other than RAS are also farnesylated and have significant roles in cancer progression. However, although several clinical trials have been conducted in cancers with high rates of ras gene mutation, such as pancreatic carcinomas, the results were less favorable than anticipated. In contrast, favorable outcomes were reported in the results of a phase II trial on head and neck carcinoma. In this review, we provide an overview of the molecular pathogenesis of NPC in terms of the process of farnesylation and discuss the potential of anti-farnesylation therapy in the treatment of NPC.

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“…Kaplan-Meier curve analysis was used to generate LRFS, DMFS, and OS survival curves. The univariate analysis of survival outcomes included a panel of covariates that may affect patient survival in NPC, including age, sex, EBV-DNA level, pathology, T stage, GTVnx volume, N stage, GTVnd volume, induction chemotherapy regimen, concurrent cisplatin dose, adjuvant chemotherapy, and RT modality (19)(20)(21)(22). Variates demonstrating a < 0.2 and RT modality were included in the subsequent multivariate analysis.…”

Section: Comparisons Of Clinical Outcomesmentioning

confidence: 99%

Volumetric modulated arc therapy versus tomotherapy for late T-stage nasopharyngeal carcinoma

Chen

Tang²,

Zhu³

et al. 2022

Front. Oncol.

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PurposeTo compare the dosimetric parameters and clinical outcomes between volumetric modulated arc therapy (VMAT) and tomotherapy for treating late T-stage nasopharyngeal carcinoma (NPC).MethodsPatients with non-metastatic late T-stage NPC who received definitive radiotherapy with tomotherapy or VMAT were selected. 1:1 propensity score matching (PSM) was used to control the balance of confounding factors. The dosimetric parameters and clinical outcomes were compared.ResultsA total of 171 patients were enrolled before matching, with 61 patients in the VMAT group and 110 patients in the tomotherapy group. In the post-PSM cohort, 54 sub-pairs of 108 patients were included after matching. Tomotherapy was superior to VMAT in the dosimetric parameters of planning target volumes, brainstem, spinal cord, lenses, and parotid glands but inferior in the optic nerves and optic chiasm. The tomotherapy group had a lower incidence of grade ≥ 3 acute mucositis (22.2% vs. 40.7%, p = 0.038) and a higher rate of complete response (83.3% vs. 66.7%, p = 0.046) after radiotherapy. However, there were no significant differences in locoregional failure-free survival (p = 0.375), distant metastasis-free survival (p = 0.529), or overall survival (p = 0.975) between the two groups.ConclusionTomotherapy is superior to VMAT in terms of most dosimetric parameters, with less acute mucositis and better short-term efficacy. There are no significant differences in the survival outcomes between the VMAT and tomotherapy groups.

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A Bayesian network meta-analysis of the primary definitive therapies for locoregionally advanced nasopharyngeal carcinoma: IC+CCRT, CCRT+AC, and CCRT alone

Cited by 3 publications

References 25 publications

Weekly versus triweekly cisplatin treatment in patients with locally advanced nasopharyngeal cancer during concurrent chemoradiotherapy

Weekly versus triweekly cisplatin treatment in patients with locally advanced nasopharyngeal cancer during concurrent chemoradiotherapy

Protein Farnesylation on Nasopharyngeal Carcinoma, Molecular Background and Its Potential as a Therapeutic Target

Volumetric modulated arc therapy versus tomotherapy for late T-stage nasopharyngeal carcinoma

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