ABSTRACT
OBJECTIVE To systematically review the efficacy and safety of induction chemotherapy before concurrent chemoradiotherapy.METHODS We comprehensively searched the CBM,Pubmed,Embase,and the Cochrane databases to identify published studies.Quality assessment of RCTs was conducted according to the methods of Cochrane collaboration.A meta-analysis was performed by using the Revman 5.3 software and Stata12.0software.Primary outcomes included overall survival (OS),progression-free survival (PFS) and overall response rate (ORR).Serious adverse events include neutropenia,anemia,skin reactions,vomiting,etc.RESULTS A Total 6 randomized controlled trials involving 1141 patients were included.There was no significant difference in 1-year survival rate,2-year survival rate,3-year survival rate,5-year survival rate between the two groups(P＞0.05).The 1-year PFS,2-year PFS,3-year PFS,5-year PFS,ORR also showed no difference between the 2 cohorts(P＞0.05).However,the incidence of grade 3 to 4 febrile neutropenia and oral mucositis was higher in the group of induction chemotherapy followed by concurrent chemoradiotherapy (OR=6.99,95％CI:2.43～20.12;OR=1.92,95％CI:1.43～2.58).CONCLUSION Additional induction chemotherapy before concurrent chemoradiotherapy does not improve OS and PFS in locally advanced HNSCC compared to concurrent chemoradiotherapy alone,and can cause a higher incidence of adverse events.
ABSTRACT
OBJECTIVE To investigate theradiosensitization of combined inhibition of signal transducer and activator of transcription 3(STAT3) and hypoxia-inducible factor-1α(HIF-1α)on laryngeal squamous carcinoma of xenograft mice and its underlying mechanisms.METHODS Xenograft mice were divided into 5 groups randomly: control group(A), irradiation group(B), irradiation and AG490 group(C), irradiation and PX478 group(D), irradiation combined AG490 and PX478 group(E). The size of xenograft tumor was measured and calculated. The expression of Ki67 and HIF-1α was detected by immunohistochemical method. Western blot was used to detect the expression of PARP1.RESULTS The size of xenograft tumor in group E was smaller compared with that in group C and group D. There were significantly difference between them respectively (t=12.367,11.598,P=0.000). The expression of HIF-1α in group E was lower than that in group C and group D respectively, and there were significantly difference respectively(t=5.422, 3.000,P<0.05). Ki67 index in group E was lower compared with that in group C and group D respectively and there were significantly difference respectively (t=4.479, 4.352,P<0.05). The level of cleaved PARP-1 in group E was higher than that in group C and group D respectively and there were significantly difference respectively (t=5.507, 7.102,P<0.05). CONCLUSION Combined inhibition of STAT3 and HIF-1α can increase the radiosensitivity of human laryngeal squamous carcinoma in the xenograft mice.