Comparison of Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: a Meta-analysis of 793 Patients from 5 Randomized Controlled Trials

Liang, Zhong‐Guo; Zhu, Xiaodong; Zhou, Zhirui; Qu, Song; Du, Yongle; Jiang, Yanming

doi:10.7314/apjcp.2012.13.11.5747

Cited by 23 publications

(14 citation statements)

References 17 publications

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“…Although concurrent chemoradiotherapy (CRT) is considered the standard for the management of locoregionally advanced NPC, 2 cycles of ICT followed by a platinum-based CRT is also used in the endemic area 7,8 . Whether such practice could maximize the benefit for patients with N3 NPC who posse the highest risk for distant metastasis is not known.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

Zhang

Chen

et al. 2017

Sci Rep

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To assess the feasibility, efficacy and safety of 4 cycles of induction chemotherapy (ICT) followed by concurrent chemoradiotherapy (CRT) in nasopharyngeal carcinoma (NPC) patients with N3 disease. ICT consisting of paclitaxel (135 mg/m2) and nedaplatin (80 mg/m2) given every 3 weeks for 4 cycles followed by cisplatin-based CRT was planned. 22 patients completed 4 cycles of TP regimen ICT and the CRT according to the protocol. After 4 cycles of ICT, the ORR of the primary site was 100% (CR 22.7%, PR 77.3%), and that of the cervical lymph nodes was 95.5% (CR 27.3%, PR 68.2%). After the completion of CRT, the ORR of the primary site was 100% (CR 81.8%, PR 18.2%), and that of the cervical lymph nodes also reached 100% (CR 86.4%, PR 3.6%). The main hematological adverse events were grade 1 to 2 (G1/G2) neutropenia/anemia without febrile neutropenia. The most frequent toxicities during CRT were G1/G2 neutropenia, asthenia, oropharyngeal mucositis and skin injury. The median follow-up time was 46.5 (14 to 75) months. The 3-year PFS, DMFS, LRFS and OS were 81.8%, 81.8%, 100%, and 90.9%, respectively. The results suggest that intensive ICT followed by CRT in NPC patients with N3 disease is effective and well tolerated.

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Section: Introductionmentioning

confidence: 99%

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

Zhang

Chen

et al. 2017

Sci Rep

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“…Additionally, our previous meta-analysis 10 showed that, compared with use of ccrt alone, ccrt followed by ac not only did not significantly improve survival, but also produced greater levels of toxicity during treatment of locally advanced npc. However, guidelines from the U.S. National Comprehensive Cancer Network have recommended use of ccrt plus ac as standard treatment for npc (category 2A) 11 .…”

Section: Resultsmentioning

confidence: 99%

Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy Compared with Concurrent Chemoradiotherapy Alone for the Treatment of Locally Advanced Nasopharyngeal Carcinoma: A Retrospective Controlled Study

Zhu

et al. 2014

Current Oncology

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Objective: We evaluated the survival benefit of providing concurrent chemoradiotherapy (ccrt) plus adjuvant chemotherapy compared with ccrt alone to patients with locally advanced nasopharyngeal carcinoma. Methods: This retrospective study included 130 patients with nasopharyngeal carcinoma treated with ccrt plus adjuvant chemotherapy from June 2005 to December 2010. Another 130 patients treated with ccrt alone during the same period were matched on age, sex, World Health Organization histology, T stage, N stage, and technology used for radiotherapy. The endpoints included overall survival, locoregional failure-free survival, distant metastasis failure-free survival, and failure-free survival. Results: At a mean follow-up of 42.1 months (range: 8–85 months), the observed hazard ratios for the group receiving ccrt plus adjuvant chemotherapy compared with the group receiving ccrt alone were: for overall survival, 0.77 [95% confidence interval (ci): 0.37 to 1.57]; for locoregional failure-free survival, 1.00 (95% ci: 0.37 to 2.71); for distant metastasis failure-free survival, 1.15 (95% ci: 0.56 to 2.37); and for failure-free survival, 1.26 (95% ci: 0.69 to 2.28). There were no significant differences in survival between the groups. After stratification by disease stage, ccrt plus adjuvant chemotherapy provided a borderline significant benefit for patients with N2–3 disease (hazard ratio: 0.35; 95% ci: 0.11 to 1.06; p = 0.052). Multivariate analyses indicated that only tumour stage was a prognostic factor for overall survival. Conclusions: Patients with locally advanced nasopharyngeal carcinoma received no significant survival benefit from the addition of adjuvant chemotherapy to ccrt. However, patients with N2–3 disease might benefit from the addition of adjuvant chemotherapy to ccrt.

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“…At the same time, other chemotherapy regimens on the basis of CCRT are also continuously being researched for some additional benefit to LANPC [4][5][6]. Among these regimens, the benefit of adjuvant chemotherapy is doubted and its side effects appear to be intolerable [5,7]. Meanwhile, induction chemotherapy (IC) is believed to be potential for its ability to kill more local and possible distant metastasis tumour cells, decrease radiation side effects by reducing radiation targets, and being tolerable for patients [4,6,8].…”

Section: Introductionmentioning

confidence: 97%

Survival benefit of induction chemotherapy in treatment for locally advanced nasopharyngeal carcinoma – A time-to-event meta-analysis

et al. 2015

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Comparison of Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: a Meta-analysis of 793 Patients from 5 Randomized Controlled Trials

Cited by 23 publications

References 17 publications

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease

Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy Compared with Concurrent Chemoradiotherapy Alone for the Treatment of Locally Advanced Nasopharyngeal Carcinoma: A Retrospective Controlled Study

Survival benefit of induction chemotherapy in treatment for locally advanced nasopharyngeal carcinoma – A time-to-event meta-analysis

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