The Effect of Induction Chemotherapy Using Docetaxel, Cisplatin, and Fluorouracil on Survival in Locally Advanced Head and Neck Squamous Cell Carcinoma: A Meta-Analysis.
The Effect of Induction Chemotherapy Using Docetaxel, Cisplatin, and Fluorouracil on Survival in Locally Advanced Head and Neck Squamous Cell Carcinoma: A Meta-Analysis.
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DOI：
10.4143/crt.2015.359
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发表时间：
2016-07
影响因子：
4.6
通讯作者：
Heo DS
中科院分区：
文献类型：
--
作者：
Kim R;Hahn S;Shin J;Ock CY;Kim M;Keam B;Kim TM;Kim DW;Heo DS
本研究的目的是比较接受同步放化疗 (CRT) 的局部晚期头颈鳞状细胞癌 (LA-HNSCC) 患者的生存率与接受多西他赛、顺铂和 5-氟尿嘧啶 (TPF) 诱导化疗 (IC) 后接受 CRT 的患者的生存率。 2015 年 4 月对 PubMed、EMBASE 和 Cochrane 图书馆数据库进行了检索，并对美国临床肿瘤学会会议（2008-2014 年）的摘要进行了审查。使用固定效应模型汇总结果，并使用 Cochrane 工具评估偏倚风险。总共确定了六项相关试验，涉及 1,280 名患者。 CRT 之前的 TPF (TPF/CRT) 与单独 CRT 相比，没有统计学上显着的总生存 (OS) 优势（风险比 [HR] 0.92；95% 置信区间 [CI]，0.79 至 1.09；p=0.339）。 TPF/CRT 组的无进展生存期 (PFS) 显着更长（HR，0.82；95% CI，0.70 至 0.95；p=0.009）。非口咽部 LA-HNSCC 患者从 TPF 中获得了最大的 OS 和 PFS 获益（分别为 HR，0.68；95% CI，0.47 至 0.99；p=0.043；HR，0.67；95% CI，0.48 至 0.94；p=0.022）。 TPF/CRT 组的完全缓解率显着提高（风险比 [RR]，1.34；95% CI，1.14 至 1.56；p < 0.001），远处转移率呈下降趋势（RR，0.65；95% CI，0.40 至 1.04；p=0.071）。对于操作系统而言，采用 TPF 和 CRT 的 IC 并不优于单独使用 CRT。然而，TPF/CRT 组的 PFS 和完全缓解率显着提高。 TPF/CRT 为非口咽部 LA-HNSCC 患者提供了明显的生存优势。
The purpose of this study was to compare the survival of patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) undergoing concurrent chemoradiotherapy (CRT) alone with that of patients undergoing induction chemotherapy (IC) using docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by CRT. A search of the PubMed, EMBASE, and Cochrane Library databases was performed in April 2015 and abstracts from the American Society of Clinical Oncology meetings (2008-2014) were reviewed. Summaries of the results were pooled using a fixed-effect model, and the risk of bias was evaluated using the Cochrane tool. A total of six relevant trials comprising 1,280 patients were identified. There was no statistically significant overall survival (OS) advantage for TPF prior to CRT (TPF/CRT) over CRT alone (hazard ratio [HR] 0.92; 95% confidence interval [CI], 0.79 to 1.09; p=0.339). Progression-free survival (PFS) was significantly longer in the TPF/CRT arms (HR, 0.82; 95% CI, 0.70 to 0.95; p=0.009). Patients with non-oropharyngeal LA-HNSCC obtained the greatest OS and PFS benefits from TPF (HR, 0.68; 95% CI, 0.47 to 0.99; p=0.043 and HR, 0.67; 95% CI, 0.48 to 0.94; p=0.022, respectively). The complete response rate was significantly increased (risk ratio [RR], 1.34; 95% CI, 1.14 to 1.56; p < 0.001), and the distant metastasis rate tended to decrease (RR, 0.65; 95% CI, 0.40 to 1.04; p=0.071) in the TPF/CRT arms. IC with TPF followed by CRT is not superior to CRT alone for OS. However, PFS and the complete response rate were significantly improved in the TPF/CRT arms. TPF/CRT for patients with nonoropharyngeal LA-HNSCC provided clear survival advantages.