Significant efficacies of neoadjuvant and adjuvant chemotherapy for nasopharyngeal carcinoma by meta-analysis of published literature-based randomized, controlled trials
Significant efficacies of neoadjuvant and adjuvant chemotherapy for nasopharyngeal carcinoma by meta-analysis of published literature-based randomized, controlled trials
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DOI：
10.1093/annonc/mdt146
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发表时间：
2013-08-01
影响因子：
50.5
通讯作者：
Xie, F. Y.
中科院分区：
文献类型：
--
作者：
OuYang, P. Y.;Xie, C.;Xie, F. Y.
我们进行了这项荟萃分析，以基于随机对照试验（RCT）来证明新辅助化疗（NACT）和辅助化疗（AC）对鼻咽癌（NPC）患者的疗效。我们全面检索了RCT的电子数据库和手稿，并从符合条件的研究中提取数据进行荟萃分析。使用随机和/或固定效应模型关注总生存率（OS）与风险比（HR）、局部复发率（LRR）和远处转移率（DMR）与相对风险（RR）。还进行了亚组和敏感性分析。NACT 组 (n = 1418) 的六项试验和 AC 组 (n = 1187) 的五项试验合格。 NACT 的死亡 HR 为 0.82 [95% 置信区间 (CI) 0.69-0.98，P = 0.03]，相当于 3 年后绝对生存率增加 5.13%。 NACT 还发现 DMR 显着降低（P = 0.0002；RR 0.69，95% CI 0.56-0.84）。但未观察到 LRR 降低（P = 0.49；RR 0.90，95% CI 0.66-1.22）。接受额外 AC 治疗的患者的 LRR 较低（P = 0.03；RR 0.71，95% CI 0.53-0.96）。但在 AC 中没有看到 OS 和 DMR 的益处。NACT 可以有效增强 OS 并降低 DMR，而不是 NPC 中的 LRR。而AC仅有助于更好地控制鼻咽癌的局部复发。
We carried out this meta-analysis to demonstrate efficacies of neoadjuvant chemotherapy (NACT) and adjuvant chemotherapy (AC) for nasopharyngeal carcinoma (NPC) patients based on randomized, controlled trials (RCTs).We comprehensively searched electronic databases and manuscripts for RCTs and extracted data from eligible studies for meta-analysis. Overall survival (OS) with hazard ratios (HRs), locoregional recurrence rate (LRR) and distant metastasis rate (DMR) with relative risks (RRs) were concerned using random and/or fixed-effects models. Subgroup and sensitivity analyses were also carried out.Six trials in NACT group (n = 1418) and five in AC group (n = 1187) were eligible. HR of death for NACT was 0.82 [95% confidence interval (CI) 0.69-0.98, P = 0.03], corresponding to an absolute survival gain of 5.13% after 3 years. Significant reduction of DMR (P = 0.0002; RR 0.69, 95% CI 0.56-0.84) was also found from NACT. But no decrease in LRR (P = 0.49; RR 0.90, 95% CI 0.66-1.22) was observed. Patients receiving additional AC had lower LRR (P = 0.03; RR 0.71, 95% CI 0.53-0.96). But no benefit of OS and DMR were seen in AC.NACT can effectively enhance OS and reduce DMR, not LRR in NPC. And AC only helps to better control locoregional recurrence of NPC.