AUTHOR=Yang Jie , Liang Zhong-Guo , Jiang Yu-Ting , Chen Kai-Hua , Li Ling , Qu Song , Zhu Xiao-Dong 

TITLE=Efficacy and Safety of Concurrent Chemoradiotherapy Combined With Induction Chemotherapy or Adjuvant Chemotherapy in Patients With Stage II–IVA Nasopharyngeal Carcinoma: A Propensity Score Matching Analysis and Meta-Analysis

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.778836

DOI=10.3389/fonc.2021.778836

ISSN=2234-943X

ABSTRACT=<sec><title>Purpose</title><p>To evaluate the efficacy and safety of induction chemotherapy (IC) combined with concurrent chemoradiotherapy (CCRT) <italic>versus</italic> CCRT combined with adjuvant chemotherapy (AC) in patients with stage II–IVA nasopharyngeal carcinoma (NPC), we conducted a retrospective study and a meta-analysis combining the results of our studies.</p></sec><sec><title>Patients and Methods</title><p>We used the propensity score matching (PSM) to balance variables. A total of 168 patients were chosen by one-to-two PSM, including 101 patients with IC + CCRT and 67 cases with CCRT + AC. We used the Kaplan–Meier curve to compare survival outcomes and also used Cox regression analysis to determine independent prognostic factors. For meta-analysis, we determined the related studies by searching the PubMed database. We used STATA v12 software to perform meta-analysis of the extracted data and calculate pooled hazard ratios, 95% confidence intervals of survival outcomes, and risk ratios for the toxicities.</p></sec><sec><title>Results</title><p>In this retrospective study, there was no significant difference in 5-year overall survival (76.9% <italic>vs</italic>. 79.0%, <italic>P</italic> = 0.966), progression-free survival (71.3% <italic>vs</italic>. 68.5%, <italic>P</italic> = 0.332), distant metastasis-free survival (80.5% <italic>vs</italic>. 74.2%, <italic>P</italic> = 0.140), and locoregional relapse-free survival (91.5% <italic>vs</italic>. 91.8%, <italic>P</italic> = 0.894) among patients with NPC with IC + CCRT <italic>versus</italic> CCRT + AC after PSM. For meta-analysis, six articles (including our study) reporting 1,052 cases of IC + CCRT and 883 cases of CCRT + AC were included in the meta-analysis. There was no difference of OS (pooled HR = 0.90, 95% CI: 0.63–1.29, <italic>P</italic> = 0.561), PFS (pooled HR = 1.07, 95% CI: 0.87–1.33, <italic>P</italic> = 0.633), DMFS (pooled HR= 0.98, 95% CI: 0.76-1.25, <italic>P</italic>=0.861), and LRRFS (pooled HR = 1.06, 95% CI: 0.76–1.48, <italic>P</italic> = 0.724).</p></sec><sec><title>Conclusion</title><p>The efficacy of IC + CCRT and CCRT + AC was comparable in patients with stage II–IVA NPC. In terms of compliance and acute adverse reactions, IC + CCRT may be a potential therapeutic strategy.</p></sec>