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A meta-analysis of neoadjuvant chemotherapy plus radiation in the treatment of locally advanced nasopharyngeal carcinoma.

OBJECTIVE
We perform this meta-analysis was to evaluate the efficacy of neoadjuvant chemotherapy followed by radiation in the treatment of locally advanced nasopharyngeal carcinoma.


MATERIALS AND METHODS
We searched the database of Medline and Wanfang to screen and included the prospective, randomized controlled trials of neoadjuvant chemotherapy plus radiation versus radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma. The pooled 5-year overall survival, 5 years disease free survival, recurrence rate, and metastasis rate were calculated by Stata version 11.0 statistical software.


RESULTS
Five prospective clinical studies were included in this meta-analysis. The total number of cases included in this study was 1277. The pooled 5 years overall survival and 5 years disease free survival were not statistical different between the neoadjuvant chemotherapy plus radiation group and radiotherapy group, respectively (P > 0.05). But the recurrence rate (odds ratio [OR] = 0.65, P < 0.05) and metastasis rate (OR = 0.61, P < 0.05) were significantly lower in the neoadjuvant chemotherapy plus radiation group compared to radiotherapy group.


CONCLUSION
Neoadjuvant chemotherapy followed by radiation can decrease the risk of recurrence and metastasis but not improve the 5 years overall survival and 5 years disease free survival compared to radiotherapy alone in the patients with locally advanced nasopharyngeal carcinoma.