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Evidence summaries

The Additional Value of Chemotherapy to Radiotherapy in Locally Advanced Nasopharyngeal Carcinoma

Concomitant chemotherapy in addition to radiation increases the overall survival in locally advanced nasopharyngeal carcinoma. Level of evidence: "A"

A systematic review 1 including 10 studies with a total of 2458 subjects was abstracted in DARE. The pooled hazard ratio (HR) of death for all studies was 0.82 (95% CI 0.71 to 0.95; P =0.01) corresponding to an absolute survival benefit of 4% after 5 years. Three categories of trials were defined according to the sequence of chemotherapy, including neoadjuvant chemotherapy, at least concomitant chemoradiotherapy, and adjuvant chemotherapy. A significant interaction term (P = 0.02) was found among these three categories. The largest effect was found for concomitant chemotherapy (2 studies), with a pooled HR of 0.48 (95% CI 0.32 to 0.72), which corresponds to a survival benefit of 20% after 5 years. Comparable results were found for the incidence of local-regional recurrences and distant metastases.

    References

    • Langendijk JA, Leemans CR, Buter J, Berkhof J, Slotman BJ. The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma: a meta-analysis of the published literature. J Clin Oncol 2004 Nov 15;22(22):4604-12. [PubMed] [DARE]

Primary/Secondary Keywords