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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


Checked for plagiarism Yes

Review by Single anonymous peer review

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

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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