| Objective：The primary target of this meta-analysis was to systematically assess theadditional value of concurrent chemotherapy(CCRT) to radiation in the intervention groupof locally advanced nasopharyngeal carcinoma (NPC) in terms of overall survival (OS),regional recurrence rate (LRR) and distant metastasis rate (DMR). The second target wasused to differentiate the difference for the treatment effectiveness between the concurrentchemoradiotherapy and concurrent chemoradiotherapy plus adjuvant chemotherapy versusthe simple radiotherapy.Methods: Abiding by a set of meta-analysis protocols, twelve phase Ⅲ clinicalrandomized trials enrolled locally advanced NPC patients in endemic areas were selectedfrom CBM, MEDLINE and EMBASE.Using STATA software to combine the size effect(risk ratio, RR), we applied randomized effect model and fixed effect model in thestatistical analysis to obtain the results.Results: Twelve clinical randomized studies including2340patients were involved.Risk ratios（RRs）of2-year,3-year and5-year OS were0.63(95%CI:0.50～0.80),0.82(95%CI:0.69～0.98),0.89(95%CI:0.73～1.08), respectively. Correspondingly, theabsolute survival benefit is8%,5%and7%, respectively. The predictable benefit for CCRTgroup were available in the results of LRR and DMR.The analytical figures of RR were0.64（95%CI:0.48～0.85）for3-year LRR and0.67（95%CI:0.56～0.81）for3-yearDMR.The comparison between CCRT plus adjuvant chemotherapy vs RT were alsoestimated. RR of3-year OS was0.73(95%CI:0.58～0.91）. The survival benefit of3-yearLRR and3-year DMR in the treatment group was obtained. RRs were0.65（95%CI:0.45～0.95）for3-year LRR and0.71（95%CI:0.54～0.92）for3-year DMR,respectively.Conclusion: Compare to the simple radiation therapy, CCRT is a better way for locally advanced nasopharyngeal carcinoma patients to improve OS. Meanwhile, patientsalso got the particular benefit of adjuvant chemotherapy. |
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