236P - Chrono-chemotherapy combined with radiotherapy for locally advanced nasopharyngeal carcinoma: A meta-analysis

Background

Nasopharyngeal carcinoma is a disease unique to Southeast Asia. Radiotherapy and chemotherapy serve as the standard treatment mode for locally advanced nasopharyngeal carcinoma (LANPC), but the efficacy is not ideal due to local recurrence and distant metastasis. Meanwhile, studies have shown concurrent chemoradiotherapy will aggravate treatment-related side effects. Chrono-chemotherapy is to select the appropriate timing of administration according to the biological rhythm of the human body, in order to improve the efficacy and reduce side effects. At present, most studies on the treatment of LANPC by hourly chemotherapy combined with radiotherapy are single-center and small-sample studies, lacking evidence-based medical evidence. Therefore, we adopted the method of meta-analysis to evaluate the efficacy and safety of chemotherapy combined with radiotherapy for LANPC in existing studies, in order to provide reference for clinical treatment.

Methods

Seven databases were searched, including the Cochrane Library (Issue 5, 2021), Pubmed, Embase, CBM, CNKI, VIP and Wanfang Database. The meta-analysis was performed by the Revman 5.3 software.

Results

Thirteen studies containing 901 patients were finally included. Compared with the conventional chemotherapy group, results showed that the effective rate, adverse reactions and immune function of the chrono-chemotherapy group was significantly higher than that of the conventional chemotherapy group. Chrono-chemotherapy combined with radiotherapy can increase the effective rate (P＜0.001), and the CD3, CD, CD4/CD8 were higher than the conventional chemotherapy group (P＜0.001), at the same time, chrono-chemotherapy group cloud reduce the III-IV°leucopenia, thrombocytopenia, gastrointestinal reaction, oral mucosa reaction, radiothermitis (P＜0.001).

Conclusions

Current evidence shows that compared with the conventional chemotherapy group, the chrono-chemotherapy with radiotherapy could improve the effective rate and immune function, and reduce adverse reactions at the same time.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.