Survival benefit of induction chemotherapy in treatment for stage III or IV locally advanced nasopharyngeal carcinoma - An updated meta-analysis and systematic review.

Abstract

PURPOSE\nThe purpose of this study was to investigate whether combined Induction chemotherapy (IC) with concurrent chemoradiotherapy (CCRT) for stage III or IV locally advanced nasopharyngeal carcinoma (LA-NPC) could achieve better survival benefits than CCRT alone.\n\n\nMATERIALS AND METHODS\nOnly randomized controlled trials were included in this study. There were two treatment regiments (IC\xa0+\xa0CCRT and CCRT alone) recruited for analysis. The end points of this meta-analysis were overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS). Then we performed a traditional meta-analysis.\n\n\nRESULTS\nSeven studies were included, including 2628 patients. Compared with using CCRT alone, IC\xa0+\xa0CCRT has better effects on overall survival (OS) [HR\xa0=\xa00.75, 95% CI\xa0=\xa00.63-0.89], locoregional recurrence-free survival (LRFS) [HR\xa0=\xa00.70, 95% CI\xa0=\xa00.56-0.86] and distant metastasis-free survival (DMFS) [HR\xa0=\xa00.65, 95% CI\xa0=\xa00.54-0.78]. Of note, the addition of IC also increases the incidence of toxic reactions and patient discomfort.\n\n\nCONCLUSION\nIC\xa0+\xa0CCRT provided better survival benefits than CCRT alone. However, patients also had a higher incidence of toxic reactions with combination therapy.