title: The role of induction and adjuvant chemotherapy in combination with concurrent chemoradiotherapy for nasopharyngeal cancer: a Bayesian network meta-analysis of published randomized controlled trials.
abstract: Whether the addition of induction chemotherapy (IC) or adjuvant chemotherapy (AC) to concurrent chemoradiotherapy (CCRT) is superior to CCRT alone for locally advanced nasopharyngeal cancer is unknown. A Bayesian network meta-analysis was performed to investigate the efficacy of CCRT, IC + CCRT, and CCRT + AC on locally advanced nasopharyngeal cancer. The overall survival (OS) with hazard ratios (HRs) and locoregional recurrence rates (LRRs) and distant metastasis rates (DMRs) with risk ratios (RRs) were investigated. After a comprehensive database search, eleven studies involving 2,626 assigned patients were included in this network meta-analysis. Compared with CCRT alone, IC + CCRT resulted in no significant improvement in OS or LRR and a marginal improvement in DMR (OS: HR =0.67, 95% credible interval (CrI) 0.32-1.18; LRR: RR =1.79, 95% CrI 0.80-3.51; DMR: RR =1.79, 95% CrI 0.24-1.04) and CCRT + AC exhibited no beneficial effects on any of the endpoints of OS, LRR, or DMR (OS: HR =0.99, 95% CrI 0.64-1.43; LRR: RR =0.78, 95% CrI 0.43-1.32; DMR: RR =0.85, 95% CrI 0.57-1.24). As a conclusion, for locally advanced nasopharyngeal cancer, no significant differences in the treatment efficacies of CCRT, IC + CCRT, and CCRT + AC were found, with the exception of a marginally significant improvement in distant control observed following IC + CCRT compared with CCRT alone.
authors.affiliation: Department of Radiation Oncology, Jiangsu Cancer Hospital affiliated with Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Radiation Oncology, Jiangsu Cancer Hospital affiliated with Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Dayong
authors.initials: D
authors.lastname: Gu
authors.affiliation: Department of Radiation Oncology, Jiangsu Cancer Hospital affiliated with Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Xia
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Radiation Oncology, Peking University First Hospital, Peking University, Beijing, People's Republic of China.
authors.forename: Xianshu
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Radiation Oncology, Jiangsu Cancer Hospital affiliated with Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Bian
keywords: adjuvant chemotherapy; concurrent chemotherapy; induction chemotherapy; nasopharyngeal cancer; network meta-analysis; radiotherapy