A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC)

• Published in: Oncotarget Vol. 7; no. 43; pp. 70185 - 70193
• Main Authors: Guan, Jian, Zhang, Yue, Li, Qinyang, Zhang, Yaowei, Li, Lu, Chen, Min, Xiao, Nanjie, Chen, Longhua
• Format: Journal Article
• Language: English
• Published: United States Impact Journals LLC 25.10.2016
• Subjects: Adult; Aged; Chemoradiotherapy - adverse effects; Cisplatin - administration & dosage; Cisplatin - adverse effects; Drug Administration Schedule; Female; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - mortality; Humans; Male; Middle Aged; Research Paper; meta-analysis; head and neck; cancer; cisplatin; therapy
• ISSN: 1949-2553; 1949-2553
• DOI: 10.18632/oncotarget.11824

This study was performed to compare the efficacies and acute toxicities in weekly- and three weekly- cisplatin based concurrent chemoradiotherapy (CCRT) for advanced HNC patients. 779 patients of 10 studies were eligible. No difference in the 2-, 3-year OS or 1-, 2-year LRFS was observed, whereas patients in three weekly CCRT arm tended to have a better 5-year OS (HR=1.79, 95%C 0.97-3.31, p=0.06). Weekly arm seemed to show less gastrointestinal toxicities (RR=0.59, 95%CI 0.34-1.02, p=0.06), but similar hematologic toxicity compared to three weekly arm. Subgroup analysis displayed more grade ≥3 mucositis (RR=1.72, p=0.01), and more chemotherapy related delay/interrupt (RR=2.68, p<0.0001) in weekly arm for non-nasopharynx carcinoma (non-NPC) HNC. We conducted the meta-analysis by searching PubMed, MEDLINE, ScienceDirect, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases. The primary endpoint was overall survival (OS) with secondary endpoints locoregional recurrence-free survival (LRFS) and grade≥3 acute adverse events. RevMan 5.2 was used to perform statistical analyses. Three weekly cisplatin-based CCRT might achieve a higher long-term OS with no significant difference in a shorter OS and LRFS. Weekly arm was associated with less gastrointestinal toxicities but more grade≥3 mucositis and chemotherapy related delay/interrupt. Large randomized trials were urgent to further define superiority of these two regimens.