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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

  • Liang, Zhong-Guo (Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Automomous Region) ;
  • Zhu, Xiao-Dong (Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Automomous Region) ;
  • Zhou, Zhi-Rui (Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Automomous Region) ;
  • Qu, Song (Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Automomous Region) ;
  • Du, You-Qin (Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Automomous Region) ;
  • Jiang, Yan-Ming (Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Automomous Region)
  • 발행 : 2012.11.30

초록

Purpose: The main objective of the present study was to evaluate the efficacy and toxicity of concurrent chemoradiotherapy followed by adjuvant chemotherapy compared with concurrent chemoradiotherapy alone in the treatment of locoregionally advanced nasopharyngeal carcinoma. Methods: The search strategy included Pubmed, Embase, the Cochrane Library, China National Knowledge Internet Web, Chinese Biomedical Database and Wanfang Database. We also searched reference lists of articles and the volumes of abstracts of scientific meetings. Randomized controlled trials (RCTs) that compared concurrent chemoradiotherapy followed by adjuvant chemotherapy with concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma were included. Meta-analysis was performed with RevMan 5.1.0. The Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) was used to rate the level of evidence. Results: Five studies were included. Risk ratios of 1.02 (95%CI 0.89-1.15), 0.93 (95%CI 0.72-1.21), 1.07 (95%CI 0.87-1.32), 0.95 (95%CI 0.80-1.13) were observed for 3 years overall survival, 5 years failure-free survival, 5 years locoregional failure-free survival and 5 years distant metastasis failure-free survival. There were no treatment-related deaths in both groups of five studies. Hematologic and gastrointestinal toxicity were the most significant for patients during adjuvant chemotherapy. The level of evidence was low. Conclusion: Compared with concurrent chemoradiotherapy alone, concurrent chemotherapy followed by adjuvant chemotherapy did not improve prognosis. More toxicity was found during adjuvant chemotherapy.

키워드

참고문헌

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피인용 문헌

  1. Optimale Behandlung des Nasopharynxkarzinoms vol.17, pp.8, 2014, https://doi.org/10.1007/s15004-014-0797-y
  2. The long-term outcomes of alternating chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a multiinstitutional phase II study vol.4, pp.8, 2015, https://doi.org/10.1002/cam4.469
  3. The efficacy and toxicities of intensive induction chemotherapy followed by concurrent chemoradiotherapy in nasopharyngeal carcinoma patients with N3 disease vol.7, pp.1, 2017, https://doi.org/10.1038/s41598-017-03963-8