Meta-analysis of chemotherapy in nasopharynx carcinoma (MAC-NPC): An update on 26 trials and 7080 patients

作者：Pierre Blanchard, Anne W.M. Lee, Alexandra Carmel, Wai Tong Ng, Jun Ma, Anthony T.�C. Chan, Ruey Long Hong, Ming‐Yuan Chen, Lei Chen, Wen‐Fei Li, Pei-Yu Huang, Dora L.�W. Kwong, Sharon Shuxian Poh, Roger K.C. Ngan, Hai‐Qiang Mai, Camille Ollivier, George Fountzilas, Li Zhang, Jean Bourhis, Anne Aupérin, Benjamin Lacas, Jean‐Pierre Pignon, Anne Aupérin, Pierre Blanchard, E Benhamou, Jean Bourhis, Alexandra Carmel, Somvilai Chakrabandhu, Anthony T.�C. Chan, Lei Chen, Ming‐Yuan Chen, Qiuyan Chen, Yong Chen, Richard J. Chappell, Cheuk‐Wai Choi, Daniel T. T. Chua, Melvin L.K. Chua, George Fountzilas, Julian P. T. Higgins, Ming‐Huang Hong, Ruey‐Long Hong, Pei-Yu Huang, Edwin P. Hui, Chin‐Fu Hsiao, Michael Kam, Georgia-Angeliki Koliou, Dora LW Kwong, Benjamin Lacas, Shu-Chuan Lai, Ka On Lam, Michael LeBlanc, Anne WM Lee, Victor Lee, Wen Fei Li, Brigette Ma, Jun Ma, Hai‐Qiang Mai, Frankie Mo, James Moon, Wai Tong Ng, Roger K.C. Ngan, Camille Ollivier, Brian O’Sullivan, Claire Petit, Jean‐Pierre Pignon, Sharon Poh, Gerta Rücker, Jonathan S. T. Sham, Yoke Lim Soong, Ying Sun, Terence Tan, Lin‐Quan Tang, Yuk Tung, Joseph Wee, Xuang Wu, Tingting Xu, Li Zhang, Yuan Zhang, Guopei Zhu · 发表于：Clinical and Translational Radiation Oncology · 年份：2021 · DOI：10.1016/j.ctro.2021.11.007 · 被引用次数：45 · 研究领域：Head and Neck Cancer Studies、Head and Neck Surgical Oncology、Esophageal Cancer Research and Treatment

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 METHODS: Published or unpublished randomized trials assessing radiotherapy (±a second chemotherapy timing) with/without chemotherapy in non-metastatic NPC patients were identified.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 chemothera...