Department of Medical Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China.
BMC Cancer. 2010 Oct 15;10:558. doi: 10.1186/1471-2407-10-558.
The main objective of this meta-analysis was to determine the clinical benefit of concurrent chemoradiotherapy (CCRT) compared with radiation alone (RT) in the treatment of nasopharyngeal carcinoma (NPC) patients in endemic geographic areas.
Using a prospective meta-analysis protocol, two independent investigators reviewed the publications and extracted the data. Published randomized controlled trials (RCTs) in which patients with NPC in endemic areas were randomly assigned to receive CCRT or RT alone were included.
Seven trials (totally 1608 patients) were eligible. Risk ratios (RRs) of 0.63 (95% CI, 0.50 to 0.80), 0.76 (95% CI, 0.61 to 0.93) and 0.74 (95% CI, 0.62 to 0.89) were observed for 2, 3 and 5 years OS respectively in favor of the CCRT group. The RRs were larger than that detected in the previously reported meta-analyses (including both endemic and non-endemic), indicating that the relative benefit of survival was smaller than what considered before.
This is the first meta-analysis of CCRT vs. RT alone in NPC treatment which included studies only done in endemic area. The results confirmed that CCRT was more beneficial compared with RT alone. However, the relative benefit of CCRT in endemic population might be less than that from previous meta-analyses.
本荟萃分析的主要目的是确定同期放化疗（CCRT）与单纯放疗（RT）治疗地方性鼻咽癌（NPC）患者的临床获益。
采用前瞻性荟萃分析方案，两名独立研究者对文献进行了回顾和数据提取。纳入了在地方性地区接受 NPC 治疗的患者被随机分配接受 CCRT 或 RT 单独治疗的已发表的随机对照试验（RCT）。
共有 7 项试验（共 1608 例患者）符合条件。2、3 和 5 年 OS 的风险比（RR）分别为 0.63（95%CI，0.50 至 0.80）、0.76（95%CI，0.61 至 0.93）和 0.74（95%CI，0.62 至 0.89），有利于 CCRT 组。RR 大于之前报道的荟萃分析（包括地方性和非地方性）中检测到的 RR，表明生存的相对获益小于之前认为的。
这是第一个仅在地方性地区进行的 NPC 治疗中 CCRT 与 RT 单独治疗的荟萃分析。结果证实 CCRT 比 RT 单独治疗更有益。然而，在地方性人群中，CCRT 的相对获益可能低于以前的荟萃分析。
