Abstract 285P
Background
Induction chemotherapy (IC) plus concurrent chemoradiotherapy (CCRT) and CCRT alone are both standard treatment regimens for managing locally advanced nasopharyngeal carcinoma (NPC). However, the results of comparisons between them in clinical trials vary. Therefore, we designed this meta-analysis to illustrate their advantages and disadvantages in patients with locally advanced NPC.
Methods
We thoroughly searched the PubMed, EMBASE, and Cochrane Library databases and then merged the effect indicators of hazard ratios (HRs) and risk ratios (RRs) using RevMan 5.1.
Results
Seven randomized controlled trials totaling 2,319 patients were included in our research. The synthesized results showed that IC plus CCRT improved overall survival (HR=0.74, 95% CI: 0.62-0.88, P< 0.001), progression-free survival (HR=0.66, 95% CI: 0.57-0.77, P< 0.001), distant metastasis-free survival (HR=0.65, 95% CI: 0.43-0.81, P<0.001) and locoregional recurrence-free survival (HR=0.68 95%, CI: 0.54-0.86, P=0.001) versus CCRT alone. It also increased the risk of anemia, thrombocytopenia, and neutropenia during CCRT. However, the incidence of leukopenia and mucositis was similar in IC and IC plus CCRT. Furthermore, the subgroup analysis showed better survival outcomes with IC plus CCRT than with CCRT alone in the triweekly cisplatin subgroup (all P<0.01), whereas IC plus CCRT could only improve progression-free survival and locoregional recurrence-free survival in the weekly cisplatin subgroup (HR= 0.71, P=0.02; and HR=0.66, P=0.03, respectively).
Conclusions
IC plus CCRT improved survival outcomes in patients with locally advanced NPC versus CCRT. For the weekly cisplatin regimen subgroup, it did not improve remote control or progression-free survival versus CCRT alone, warranting further clarification.
Clinical trial identification
The protocol of our study has been registered with PROSPERO, and the number is CRD42018087074.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
People's Government of Yunnan Province (no grant number is applicable).
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
253P - Non-Epithelial Tumours of Ovary, An Experience from Qatar
Presenter: Ammar Madani
Session: e-Poster Display Session
260P - A phase I study of copanlisib, a pan-class I phosphatidylinositol 3-kinase (PI3K) inhibitor, in Chinese patients with relapsed indolent non-Hodgkin lymphoma (iNHL)
Presenter: Yuqin Song
Session: e-Poster Display Session
261P - Clinical outcomes of early-progressed follicular lymphoma in Korea: A multicenter, retrospective analysis
Presenter: Jun Ho Yi
Session: e-Poster Display Session
262P - Correlation between phosphorylated pI3K expression, phosphorylated AKT, and phosphorylated MTOR with serum dehydrogenase lactate level in non-Hodgkin lymphoma
Presenter: Hary Gustian
Session: e-Poster Display Session
263P - Good response to chemotherapy in primary CNS lymphoma may not translate into significant neurocognitive improvement in comatose patients
Presenter: Ryan Lim
Session: e-Poster Display Session
264P - Treatment outcome of primary testicular lymphoma patients treated in tertiary care centre in Chennai
Presenter: Sivasubramaniam Kumaravelu
Session: e-Poster Display Session
271P - Cost-effectiveness of pembrolizumab as monotherapy or in combination with chemotherapy versus EXTREME regimen for the first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma in Taiwan
Presenter: Cheng Hsu Wang
Session: e-Poster Display Session
272P - Early metabolic changes in PET metrics over initial 8 weeks of treatment in patients with advanced head neck squamous cell carcinomas treated with chemotherapy
Presenter: Ashish Vaidya
Session: e-Poster Display Session
273P - Long term outcomes of locally advanced & borderline resectable esthesioneuroblastoma and sinonasal tumour with neuroendocrine differentiation treated with neoadjuvant chemotherapy
Presenter: Vikas Talreja
Session: e-Poster Display Session
274P - Comparing comorbidity indices in predicting 90-day mortality after radical radiotherapy for head and neck cancer
Presenter: Therese Tsui
Session: e-Poster Display Session