title: Chemoradiotherapy is superior to radiotherapy alone after surgery in advanced squamous cell carcinoma of the head and neck: a systematic review and meta-analysis.
abstract: BACKGROUND
  To conduct a comprehensive review whether chemotherapy to radiotherapy after surgical resection could improve the loco regional control and survival compared with postoperative radiotherapy alone.
  
  
  METHODS
  A comprehensive search of PubMed for relevant studies comparing patients with advanced squamous cell carcinoma of the head and neck undergoing chemoradiotherapy or radiotherapy alone after resection was conducted.
  
  
  RESULTS
  The meta-analysis demonstrated significant benefits from adding chemotherapy to radiotherapy in local-regional control, disease-free survival and overall survival (p < 0.00001). The adverse effects include hematological and non-hematological toxicities. Although the acute and late toxicities occurred more frequently and severely in chemoradiation combined treatment, there was no significant difference compared with radiotherapy alone, but the estimated pooled RR of mucositis or dysphagia was 1.69 (p < 0.00001) in favor of radiotherapy regimens.
  
  
  CONCLUSIONS
  Postoperative chemotherapy adding to radiotherapy is superior to radiotherapy alone. Patients with chemoradiotherapy after surgical resection can achieve the higher LRC, longer DFS and OS.
authors.affiliation: Department of Head and Neck Surgery, Zhejiang Cancer Hospital Hangzhou 310022, China ; Wenzhou Medical University Wenzhou 325035, China.
authors.forename: Jinbiao
authors.initials: J
authors.lastname: Shang
authors.affiliation: Department of Head and Neck Surgery, Zhejiang Cancer Hospital Hangzhou 310022, China ; Wenzhou Medical University Wenzhou 325035, China.
authors.forename: Jialei
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Head and Neck Surgery, Zhejiang Cancer Hospital Hangzhou 310022, China ; Wenzhou Medical University Wenzhou 325035, China.
authors.forename: Qianbo
authors.initials: Q
authors.lastname: Han
authors.affiliation: Wenzhou Medical University Wenzhou 325035, China ; Department of Radiation Oncology, Zhejiang Cancer Hospital Hangzhou 310022, China.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Chemotherapy, Zhejiang Cancer Hospital Hangzhou 310022, China.
authors.forename: Xinmin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Head and Neck Surgery, Zhejiang Cancer Hospital Hangzhou 310022, China.
authors.forename: Kejin
authors.initials: K
authors.lastname: Wang
keywords: Head and neck neoplasms; chemoradiotherapy; meta-analysis; review