Neoadjuvant chemotherapy,adjuvant chemotherapy and radiotherapy or their combinations for nasopharyngeal cancer:a Meta-analysis on randomized controlled trials / 第三军医大学学报

ABSTRACT

Objective To compare the beneficial efficiency of chemotherapy combined with radiotherapy or radiotherapy alone,for locally advanced nasopharyngeal carcinoma.Methods A systematic review of randomized controlled trials(RCT) on this subject was performed.Mortality rate(MR),event-free survival(EFS),loco-regional control rate(LRR) and distant metastasis rate(DMR) were analyzed.Meta-analysis was carried out to compare the efficiency of adding chemotherapy to radiotherapy or radiotherapy alone.Results Totally 16 trials involving 3 768 patients were included.Our results showed that① Patients receiving concomitant chemotherapy had better 2-,3-and 5-year MR,EFS,LRR and DMR compared with those receiving radiotherapy alone;② Neoadjuvant chemotherapy improved LRR and DMR in patients with nasopharyngeal carcinoma when compared with radiotherapy alone;③ There was no significant difference between adjuvant chemotherapy and radiotherapy alone in MR,EFS,LRR and DMR.Conclusion Adding chemotherapy to radiotherapy improves survival rate and EFS of patients with nasopharyngeal carcinoma,reduces LRR and DMR of these patients when compared with radiotherapy alone.We believe that adding chemotherapy to radiotherapy is a very effective therapy for patients with locally advanced nasopharyngeal carcinoma.