Which treatment is better than concurrent chemoradiotherapy about survival for stage III or IV locally advanced nasopharyngeal carcinoma? An updated Bayesian network meta-analysis of randomized controlled trials

Fang, Lucheng; Shi, Licai; Wang, Wen; Hu, Tingting; Rao, Xingwang

doi:10.1007/s00405-021-06614-x

Cited by 6 publications

(7 citation statements)

References 43 publications

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“…Therefore, the treatment side effects and other related profiles are not revealed in the results. However, the current meta‐analytic results reconfirmed the significant benefits for survival of patients with locoregionally advanced NPC seen in previous meta‐analyses 26–35 . Therefore, the benefits of ICT for the survival condition of locoregionally advanced NPC might be consistent and persuasive.…”

Section: Discussionsupporting

confidence: 79%

“…Our meta‐analysis enrolled the latest studies evaluating ICT with CCRT for patients with locoregionally advanced NPC 18,19,24 . The results might be more updated than previous meta‐analyses 26–31 . We also analyzed more survival indicators than the previous meta‐analyses 27–29 .…”

Section: Discussionmentioning

confidence: 99%

“… 18 , 19 , 24 The results might be more updated than previous meta‐analyses. 26 , 27 , 28 , 29 , 30 , 31 We also analyzed more survival indicators than the previous meta‐analyses. 27 , 28 , 29 In addition, our meta‐analysis purely focused on randomized controlled trials, which minimizes bias from retrospective studies or cohort studies as found in other meta‐analyses.…”

Section: Discussionmentioning

confidence: 99%

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Survival after induction chemotherapy in locoregional advanced nasopharyngeal carcinoma: An updated systematic review and meta‐analysis

Meng,

Huang,

Huang

2023

Laryngoscope Investig Oto

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BackgroundInduction chemotherapy (ICT) augmentation is a common strategy for standard concurrent chemoradiotherapy (CCRT) of locoregionally advanced nasopharyngeal carcinoma (NPC). The survival condition is a crucial issue for patients with locoregionally advanced NPC. The survival of ICT patients with CCRT treatment versus standard CCRT alone should be elucidated via a systemic review and meta‐analysis of randomized clinical trials.MethodsWe compared ICT with CCRT and CCRT alone treatment to determine if ICT with CCRT can be associated with a significant benefit of survival conditions versus CCRT. Different survival indicators were analyzed for the ICT with CCRT. Twelve studies with a total of 3711 patients with locoregionally advanced NPC were enrolled. The focused outcome was the overall survival, progression‐free survival, distant metastasis‐free survival, and locoregional recurrence‐free survival.ResultsOur results showed that ICT with CCRT is associated with a significant benefit for the overall survival status versus CCRT treatment. Similar significant benefits in the survival condition were seen in progression‐free survival, distant metastasis‐free survival, and locoregional recurrence‐free survival.ConclusionsThe updated meta‐analysis results suggest that the ICT with CCRT might be associated with significant benefits of survival in overall, progression‐free, distant metastasis‐free, as well as locoregional recurrence‐free dimensions versus CCRT treatment. However, the bias of different kinds, doses, and regimens of chemotherapy agents and radiotherapy should not be ignored.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Survival after induction chemotherapy in locoregional advanced nasopharyngeal carcinoma: An updated systematic review and meta‐analysis

Meng,

Huang,

Huang

2023

Laryngoscope Investig Oto

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“…Not only does it show advantages compared to CCRT, but among IC+CCRT, CCRT, CCRT+AC, IC+RT, and RT alone, a meta-analysis including only randomized controlled trials found that IC+CCRT may be the best option for the treatment of LANPC. Although this conclusion came from an indirect comparison, IC+CCRT outperformed CCRT in terms of survival benefit, but CCRT+AC was not superior to CCRT alone in regards of survival benefit [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Induction versus adjuvant chemotherapy combined with concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: a retrospective cohort study

Liu

et al. 2022

Aging

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Background: Currently available evidence favors the combination of chemotherapy with concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma (LANPC). However, the optimal timing for additional chemotherapy is unclear. This study was conducted to compare the efficacy and toxicity of induction chemotherapy plus concurrent chemoradiotherapy (IC+CCRT) versus concurrent chemoradiotherapy plus adjuvant chemotherapy (CCRT+AC). Methods: Two medical centers in China enrolled patients with LANPC (stage III-IVB) between January 2009 and May 2020. Through the use of propensity score matching (PSM), baseline characteristics were balanced. The primary endpoint was overall survival (OS), which was evaluated by the Kaplan-Meier method and log-rank test. Potential independent prognostic factors were identified using univariate and multivariate Cox proportional hazard analyses. Based on the chi-squared test, we compared the adverse events associated with treatment between the groups. Results: After the implementation of PSM, 159 patients treated with IC+CCRT and 72 patients treated with CCRT+AC were eventually enrolled in this study. There was no significant difference between patients treated with IC+CCRT and CCRT+AC in terms of 3-year OS (94.7% versus 90.9%, p=0.816), progression-free survival (PFS) (91.2% versus 83.1%, p=0.588), locoregional recurrence-free survival (LRFS) (92.5% versus 81.8%, p=0.478), or distant metastasis-free survival (DMFS) (93.4% versus 88.2%, p=0.783). There was no prognostic significance of the treatment for OS, PFS, LRFS, or DMFS (all p > 0.05) in the univariate and multivariate analyses. Patients treated with CCRT+AC had a higher incidence of grade 3 to 4 leucopenia (p=0.001) and neutropenia (p=0.001) than those treated with IC+CCRT. Conclusions: IC plus CCRT achieved comparable survival outcomes to CCRT plus AC and had a lower incidence of toxicity.

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“…Zhang B et al [16], and Fang L et al [17] also analyzed the results of 6 randomized controlled trials and concluded that conformal RT combined with platinum-based CT may be beneficial for patient with locally advanced NPC survival.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between Patients Treated with Conventional Radiotherapy and IMRT with Chemotherapy for Stage III - IVA Nasopharyngeal Carcinoma: A Single Institution Retrospective Report

Keita,

Li,

Bah

et al. 2023

JCT

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Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of two different treatment regimens for locally advanced nasopharyngeal carcinoma. Methods: From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA nasopharyngeal carcinoma were treated. Of these, 137 received conventional radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy plus chemotherapy. Chemotherapy was given either as induction, concurrent or adjuvant therapy. Survival rates were calculated according to Kaplan Meier and compared with the Log-rank test. The RTOG or EORTC criteria were used to assess acute and late toxicities. Results: The median follow-up time was 21.5 months, and the 2-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates in the conventional radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively; in the intensity-modulated radiotherapy plus chemotherapy group, they were 97%, 84%, and 100%, respectively. The difference in survival between the two groups was significant (χ 2 = 5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion: Compared with conventional radiotherapy plus chemotherapy, intensity-modulated radiotherapy plus chemotherapy How to cite this paper:

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Which treatment is better than concurrent chemoradiotherapy about survival for stage III or IV locally advanced nasopharyngeal carcinoma? An updated Bayesian network meta-analysis of randomized controlled trials

Cited by 6 publications

References 43 publications

Survival after induction chemotherapy in locoregional advanced nasopharyngeal carcinoma: An updated systematic review and meta‐analysis

Survival after induction chemotherapy in locoregional advanced nasopharyngeal carcinoma: An updated systematic review and meta‐analysis

Induction versus adjuvant chemotherapy combined with concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: a retrospective cohort study

Comparative Study between Patients Treated with Conventional Radiotherapy and IMRT with Chemotherapy for Stage III - IVA Nasopharyngeal Carcinoma: A Single Institution Retrospective Report

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