A systematic review of neoadjuvant chemotherapy in the treatment of advanced nasopharyngeal carcinoma

Abstract:

Objective：To evaluate the efficacy and safety of neoadjuvant chemotherapy（NACT） in the treatment of advanced nasopha－ryngeal carcinoma. Methods：Literature was searched online in Pubmed，Embase，Cochrane Library before April 1st，2013. Only ran－domized controlled trials（RCTs） with regard to NACT were included. Results：A total of 7 trials with 1 463 cases were included. Meta analyses demonstrated that NACT significantly improved the recurrence-free survival（HR：0.74，95%CI：0.64，0.86，P<0.001） and overall survival（HR：0.81，95%CI：0.68，0.96，P=0.013），decreased the locoregional recurrence（RR：0.80，95%CI：0.67，0.97，P=0.022） and the distant metastasis（RR：0.70，95%CI：0.58，0.85，P<0.001）. During NACT，the common grade 3-4 adverse events were hair loss（46.4%），nausea/vomiting（20.1%），neutropenia（35.9%）. However，NACT didn’t increased the treatment-related death（P=0.806） and grade 3-4 adverse events after treatments. Conclusions：NACT is an effective and safe modality for patients with advanced nasopharyngeal carcinoma.