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http://ir.nhri.org.tw/handle/3990099045/14152
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| Title: | Meta-analysis of chemotherapy in nasopharynx carcinoma (MAC-NPC): An update on 26 trials and 7080 patients |
| Authors: | Blanchard, P;Lee, AWM;Carmel, A;Wai Tong, N;Ma, J;Chan, ATC;Hong, RL;Chen, MY;Chen, L;Li, WF;Huang, PY;Kwong, DLW;Poh, SSX;Ngan, R;Mai, HQ;Ollivier, C;Fountzilas, G;Zhang, L;Bourhis, J;Aupérin, A;Lacas, B;Pignon, JP;Benhamou, E;Chakrabandhu, S;Tc Chan, A;Chen, QY;Chen, Y;Chappell, RJ;Choi, H;Tt Chua, D;Lee Kiang Chua, M;Higgins, J;Hong, MH;Hong, RL;Pun Hui, E;Hsiao, CF;Kam, M;Angeliki Koliou, G;Lw Kwong, D;Lai, SC;On Lam, K;LeBlanc, ML;Wm Lee, A;Fun Victor Lee, H;Fei Li, W;Ma, B;Mo, F;Moon, J;Tong Ng, W;O'Sullivan, B;Petit, C;Pierre Pignon, J;Poh, SX;Rücker, G;Sham, J;Lim Soong, Y;Sun, Y;Tan, T;Tang, LQ;Tung, Y;Wee, J;Wu, X;Xu, T;Zhang, Y;Zhu, G;on behalf of the MACNPCcG |
| Contributors: | Institute of Population Health Sciences |
| Abstract: | Purpose: Chemotherapy, when added to radiotherapy, improves survival in locally advanced nasopharyngeal carcinoma (NPC). This article presents the second update of the Meta-Analysis of Chemotherapy in NPC. Methods: Published or unpublished randomized trials assessing radiotherapy (±a second chemotherapy timing) with/without chemotherapy in non-metastatic NPC patients were identified. Updated data were sought for studies included in the previous rounds of the meta-analysis. The primary endpoint was overall survival. All trials were analyzed following the intent-to-treat principle using a fixed-effects model. Treatments were classified in five subsets according to chemotherapy timing. The statistical analysis plan was pre-specified. Results: Eighteen new trials were identified. Individual patient data were available for seven. In total, the meta-analysis now included 26 trials and 7,080 patients. The addition of chemotherapy reduced the risk of death, with a hazard ratio (HR) of 0.79 (95% confidence interval (CI) [0.73; 0.85]), and an absolute survival increase at 5 and 10 years of 6.1% [+3.9; +8.3] and + 8.4% [+5.7; +11.1], respectively. The largest effect was observed for concomitant + adjuvant, induction (with concomitant in both arms) and concomitant chemotherapy, with respective HR [95%CI] of 0.68 [0.59; 0.79] (absolute survival increase at 5 years: 12.3% (7.0%;17.6%)), 0.73 [0.63; 0.86] (6.0% (2.5%;9.5%)) and 0.81 [0.70; 0.92] (5.2% (0.8%;9.6%)). The benefit of chemotherapy was also demonstrated by improvement in progression-free survival, cancer mortality, locoregional control and distant control. There was a significant interaction between patient age and chemotherapy effect. Conclusion: This updated meta-analysis confirms the benefit of concomitant chemotherapy and concomitant + adjuvant chemotherapy, and suggests that addition of induction or adjuvant chemotherapy to concomitant chemotherapy improves tumor control and survival. The benefit of chemotherapy decreases with increasing patient age. |
| Date: | 2022-01 |
| Relation: | Clinical and Translational Radiation Oncology. 2022 Jan;32:59-68. |
| Link to: | http://dx.doi.org/10.1016/j.ctro.2021.11.007 |
| JIF/Ranking 2023: | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2405-6308&DestApp=IC2JCR |
| Cited Times(Scopus): | https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85124746344 |
| Appears in Collections: | [蕭金福] 期刊論文
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| SCP85124746344.pdf | | 2244Kb | Adobe PDF | 171 | View/Open |
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