Nasopharyngeal carcinoma meta-analysis: survival boosted by chemoradiotherapy and induction chemotherapy

  • Zhang B & al.
  • JAMA Netw Open
  • 2 Oct 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Concurrent chemoradiotherapy (CCRT) and induction chemotherapy (IC) are associated with improved OS, PFS, distant metastasis-free survival (DMFS), and locoregional recurrence-free survival (LRFS) compared with RT in patients with nasopharyngeal carcinoma (NPC).
  • Adjuvant chemotherapy (AC) is not associated with these benefits, according to a systematic review and meta-analysis.

Why this matters

  • CCRT is now a standard treatment for locoregionally advanced NPC, but the relative benefits of IC and AC are still unclear.

Key results

  • CCRT was associated with improved OS (HR, 0.66; P=.002), PFS (HR, 0.73; P=.01), DMFS (HR, 0.69; P<.001 and lrfs p=".002)" compared with rt in pooled analyses.>
  • IC was associated with improved OS (HR, 0.84; P=.007), PFS (HR, 0.73; P<.001 dmfs p and lrfs>
  • AC was not associated with improved OS (HR, 0.98; P=.87), PFS (HR, 0.86; P=.17), DMFS (HR, 0.84; P=.21), or LRFS (HR, 0.80; P=.16).

Study design

  • 8036 patients with NPC from 28 randomized clinical trials were included in the meta-analysis.
  • Funding: National Natural Science Foundation; Guangzhou Science Technology and Innovation Commission; China Postdoctoral Science Foundation.

Limitations

  • No analysis of specific RT strategies.