Effect of Induction Chemotherapy in Nasopharyngeal Carcinoma: An Updated Meta-Analysis

Previous meta-analysis had evaluated the effect of induction chemotherapy in nasopharyngeal carcinoma. But two trials with opposite findings were not included and the long-term result of another trial significantly differed from the preliminary report. This updated meta-analysis was thus warranted....

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Published inFrontiers in oncology Vol. 10; p. 591205
Main Authors Yang, Shan-Shan, Guo, Jian-Gui, Liu, Jia-Ni, Liu, Zhi-Qiao, Chen, En-Ni, Chen, Chun-Yan, OuYang, Pu-Yun, Han, Fei, Xie, Fang-Yun
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 08.01.2021
Subjects
induction chemotherapy
meta-analysis
nasopharyngeal carcinoma
Oncology
radiotherapy
updated
meta-analysis
radiotherapy
nasopharyngeal carcinoma
induction chemotherapy
updated
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Summary:Previous meta-analysis had evaluated the effect of induction chemotherapy in nasopharyngeal carcinoma. But two trials with opposite findings were not included and the long-term result of another trial significantly differed from the preliminary report. This updated meta-analysis was thus warranted. Literature search was conducted to identify randomized controlled trials focusing on the additional efficacy of induction chemotherapy in nasopharyngeal carcinoma. Trial-level pooled analysis of hazard ratio (HR) for progression free survival and overall survival and risk ratio (RR) for locoregional control rate and distant control rate were performed. Twelve trials were eligible. The addition of induction chemotherapy significantly prolonged both progression free survival (HR=0.68, 95% confidence interval [CI] 0.60-0.76, p<0.001) and overall survival (HR=0.67, 95% CI 0.54-0.80, p<0.001), with 5-year absolute benefit of 11.31% and 8.95%, respectively. Locoregional (RR=0.80, 95% CI 0.70-0.92, p=0.002) and distant control (RR=0.70, 95% CI 0.62-0.80) rates were significantly improved as well. The incidence of grade 3-4 adverse events during the concurrent chemoradiotherapy was higher in leukopenia (p=0.028), thrombocytopenia (p<0.001), and fatigue (p=0.038) in the induction chemotherapy group. This meta-analysis supported that induction chemotherapy could benefit patients with nasopharyngeal carcinoma in progression free survival, overall survival, locoregional, and distant control rate.
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This article was submitted to Head and Neck Cancer, a section of the journal Frontiers in Oncology
These authors have contributed equally to this work
Reviewed by: Maria Cossu Rocca, European Institute of Oncology (IEO), Italy; Marianne Paesmans, Jules Bordet Institute, Belgium
Edited by: Dirk Van Gestel, Free University of Brussels, Belgium
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2020.591205