Meng Yiyu, Huang Chao, Huang Wu
Department of Otorhinolaryngology Lishui People's Hospital Lishui China.
Laryngoscope Investig Otolaryngol. 2023 Aug 19;8(5):1217-1225. doi: 10.1002/lio2.1133. eCollection 2023 Oct.
Induction chemotherapy (ICT) augmentation is a common strategy for standard concurrent chemoradiotherapy (CCRT) of locoregionally advanced nasopharyngeal carcinoma (NPC). The survival condition is a crucial issue for patients with locoregionally advanced NPC. The survival of ICT patients with CCRT treatment versus standard CCRT alone should be elucidated via a systemic review and meta-analysis of randomized clinical trials.
We compared ICT with CCRT and CCRT alone treatment to determine if ICT with CCRT can be associated with a significant benefit of survival conditions versus CCRT. Different survival indicators were analyzed for the ICT with CCRT. Twelve studies with a total of 3711 patients with locoregionally advanced NPC were enrolled. The focused outcome was the overall survival, progression-free survival, distant metastasis-free survival, and locoregional recurrence-free survival.
Our results showed that ICT with CCRT is associated with a significant benefit for the overall survival status versus CCRT treatment. Similar significant benefits in the survival condition were seen in progression-free survival, distant metastasis-free survival, and locoregional recurrence-free survival.
The updated meta-analysis results suggest that the ICT with CCRT might be associated with significant benefits of survival in overall, progression-free, distant metastasis-free, as well as locoregional recurrence-free dimensions versus CCRT treatment. However, the bias of different kinds, doses, and regimens of chemotherapy agents and radiotherapy should not be ignored.
诱导化疗(ICT)强化是局部晚期鼻咽癌(NPC)标准同步放化疗(CCRT)的常见策略。生存状况是局部晚期NPC患者的关键问题。应通过对随机临床试验的系统评价和荟萃分析来阐明接受CCRT治疗的ICT患者与单纯标准CCRT患者的生存情况。
我们比较了ICT联合CCRT与单纯CCRT治疗,以确定ICT联合CCRT相对于CCRT是否能带来显著的生存获益。对接受ICT联合CCRT治疗的患者分析了不同的生存指标。纳入了12项研究,共3711例局部晚期NPC患者。重点观察指标为总生存期、无进展生存期、无远处转移生存期和无局部区域复发生存期。
我们的结果表明,与CCRT治疗相比,ICT联合CCRT在总体生存状况方面具有显著益处。在无进展生存期、无远处转移生存期和无局部区域复发生存期方面也观察到了类似的显著生存获益。
更新的荟萃分析结果表明,与CCRT治疗相比,ICT联合CCRT在总体、无进展、无远处转移以及无局部区域复发方面可能具有显著的生存益处。然而,化疗药物和放疗的种类、剂量及方案的偏差不容忽视。