The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population: a meta-analysis of the phase III randomized trials.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Medical Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China.
Li
L
Zhang
Chong
C
Zhao
Bijesh
B
Ghimire
Ming-Huang
MH
Hong
Qing
Q
Liu
Yang
Y
Zhang
Ying
Y
Guo
Yi-Jun
YJ
Huang
Zhong-Zhen
ZZ
Guan
D002277:Carcinoma; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy / Q000379:methods*; D004358:Drug Therapy / Q000379:methods; D006801:Humans; D008495:Medical Oncology / Q000379:methods*; D015201:Meta-Analysis as Topic; D015233:Models, Statistical; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D009362:Neoplasm Metastasis; D011379:Prognosis; D011446:Prospective Studies; D011878:Radiotherapy / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors; D016896:Treatment Outcome