顺铂或西妥昔单抗与放疗联合用于局部晚期头颈部鳞状细胞癌患者的Meta分析

Concurrent cisplatin or cetuximab with radiotherapy in patients with locally advanced head and neck squamous cell carcinoma: A meta-analysis.

作者信息

Tang Wen-Hua, Sun Wei, Long Guo-Xian

机构信息

Department of Oncology, Chengdu Seventh People's Hospital, Chengdu, Sichuan, China.

Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Medicine (Baltimore). 2020 Sep 4;99(36):e21785. doi: 10.1097/MD.0000000000021785.

BACKGROUND

Concurrent cisplatin with radiotherapy (CRT) or concurrent cetuximab with radiotherapy (BRT) improves outcomes in locally advanced head and neck squamous cell carcinoma (HNSCC) compared with radiotherapy alone. Nevertheless, a detailed comparison between CRT and BRT in locally advanced HNSCC is required due to inconclusive results.

METHODS

A comprehensive literature search was conducted on PubMed, Web of Science, Cochrane databases, and EMBASE. Studies that evaluated CRT vs BRT in locally advanced HNSCC were included. The primary outcome that was overall survival (OS), whereas the secondary outcomes were progression-free survival (PFS), locoregional control (LRC), and distant metastasis-free survival (DMFS). Pooled hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were used to evaluate prognosis. All the analyses were performed using Stata Statistical Software 12.0.

RESULTS

Twenty-three studies, with a total of 8701 patients, were considered eligible and included in this meta-analysis. Our results revealed that patients treated with CRT had longer OS (HR = 0.51, 95%CI, 0.41-0.64, P < .001), PFS (HR = 0.37, 95%CI, 0.23-0.60, P < .001), LRC (HR = 0.46, 95%CI, 0.37-0.57, P < .001), and DMFS (HR = 0.56, 95%CI, 0.40-0.77, P < .001) than those treated with BRT. Furthermore, the results of the subgroup analyses were consistent with the primary analysis.

CONCLUSIONS

CRT has a better OS, PFS, LRC, and DMFS than BRT in locally advanced HNSCC, and should be the preferred treatment for patients with the disease.

背景

与单纯放疗相比，顺铂同步放疗（CRT）或西妥昔单抗同步放疗（BRT）可改善局部晚期头颈部鳞状细胞癌（HNSCC）的治疗效果。然而，由于结果尚无定论，因此需要对局部晚期HNSCC的CRT和BRT进行详细比较。

方法

在PubMed、科学网、Cochrane数据库和EMBASE上进行了全面的文献检索。纳入评估局部晚期HNSCC中CRT与BRT的研究。主要结局为总生存期（OS），次要结局为无进展生存期（PFS）、局部区域控制（LRC）和无远处转移生存期（DMFS）。采用合并风险比（HRs）和相应的95%置信区间（CIs）来评估预后。所有分析均使用Stata统计软件12.0进行。

结果

23项研究，共8701例患者，被认为符合纳入标准并纳入本荟萃分析。我们的结果显示，与接受BRT治疗的患者相比，接受CRT治疗的患者的OS（HR = 0.51，95%CI，0.41 - 0.64，P <.001）、PFS（HR = 0.37，95%CI，0.23 - 0.60，P <.001）、LRC（HR = 0.46，95%CI，0.37 - 0.57，P <.001）和DMFS（HR = 0.56，95%CI，0.40 - 0.77，P <.001）更长。此外，亚组分析的结果与主要分析一致。