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Concurrent chemoradiotherapy versus radiotherapy alone for locoregionally advanced nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy: a meta-analysis

Authors He Y, Guo T, Guan H, Wang J, Sun Y, Peng X

Received 21 December 2017

Accepted for publication 23 March 2018

Published 6 June 2018 Volume 2018:10 Pages 1419—1428

DOI https://doi.org/10.2147/CMAR.S160469

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Lu-Zhe Sun


Yan He,1,* Tao Guo,2,* Hui Guan,1 Jingjing Wang,1 Yu Sun,1 Xingchen Peng1

1Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; 2Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China

*These authors contributed equally to this work

Purpose:
In this study, we attempted to compare the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with radiotherapy alone (RT) for locoregionally advanced nasopharyngeal carcinoma (LANPC) in the era of intensity-modulated radiotherapy (IMRT) by meta-analysis.
Materials and methods: We searched databases, and all randomized controlled trials meeting the inclusion criteria were utilized for a meta-analysis with RevMan 5.3 based on the Cochrane methodology.
Results: Fifteen studies were found suitable based on the inclusion criteria. CCRT not only significantly improved the overall response rate (risk ratio [RR]=0.53, 95% CI 0.43–0.66) and the complete response rate (RR=0.60, 95% CI 0.51–0.71) but also contributed to longer overall survival. The incidence of grade 3–4 adverse events from CCRT group increased in hematologic toxicity (RR 2.25, 95% CI 1.54–3.29), radiation-induced oral mucositis (RR 1.64, 95% CI 1.14–2.35), and radiodermatitis (RR 1.80, 95% CI 1.13–2.88).
Conclusion: Compared with IMRT alone, CCRT provided survival benefit with acceptable toxicity in patients with LANPC. However, we need multicenter randomized controlled trials and long-term follow-up to evaluate the eventual efficacy and toxicity of concurrent chemotherapy plus IMRT.

Keywords: locoregionally advanced nasopharyngeal carcinoma, intensity-modulated radiotherapy, concurrent chemoradiotherapy, meta-analysis

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