title: Combination of taxanes, cisplatin and fluorouracil as induction chemotherapy for locally advanced head and neck cancer: a meta-analysis.
abstract: BACKGROUND
  Some investigations have suggested that induction chemotherapy with a combination of taxanes, cisplatin and fluorouracil (TPF) is effective in locally advanced head and neck cancer. However, other trials have indicated that TPF does not improve outcomes. The objective of this study was to compare the efficacy and safety of TPF with a cisplatin and fluorouracil (PF) regimen through a meta-analysis.
  
  
  METHODS
  Four randomized clinical trials were identified, which included 1,552 patients with locally advanced head and neck cancer who underwent induction chemotherapy with either a TPF or PF protocol. The outcomes included the 3-year survival rate, overall response rate and different types of adverse events. Risk ratios (RRs) and their 95% confidence intervals (CIs) were pooled using RevMan 5.1 software.
  
  
  RESULTS
  The 3-year survival rate (51.0% vs. 42.4%; p = 0.002), 3-year progression-free survival rate (35.9% vs. 27.2%; p = 0.007) and overall response to chemotherapy (72.9% vs. 62.1%; p<0.00001) of the patients in the TPF group was statistically superior to those in the PF group. In terms of toxicities, the incidence of febrile neutropenia (7.0% vs. 3.2%; p = 0.001) and alopecia (10.8% vs. 1.1%; p<0.00001) was higher in the TPF group.
  
  
  CONCLUSIONS
  The TPF induction chemotherapy regimen leads to a significant survival advantage with acceptable toxicity rates for patients with locally advanced head and neck cancer compared with the PF regimen.
authors.affiliation: Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Qin
authors.forename: Jie
authors.initials: J
authors.lastname: Luo
authors.forename: Yuan-Ping
authors.initials: YP
authors.lastname: Zhu
authors.forename: Hai-Li
authors.initials: HL
authors.lastname: Xie
authors.forename: Wei-Qiang
authors.initials: WQ
authors.lastname: Yang
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Lei
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D015233:Models, Statistical; D016017:Odds Ratio; D015996:Survival Rate; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D043823:Taxoids; D002945:Cisplatin; D005472:Fluorouracil