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Concurrent chemoradiotherapy versus radiotherapy alone for stage II nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

Concurrent chemoradiotherapy has long been a standardized therapy for localized advanced nasopharyngeal cancer. It is widely used in clinical applications. In contrast, NCCN guidelines highlight that the efficacy of concurrent chemoradiotherapy for stage II nasopharyngeal cancer in the new era of intensity-modulated radiotherapy has not been defined. Thus, we systematically reviewed the significance of concurrent chemoradiotherapy for stage II nasopharyngeal cancer.

Methods

We searched the relevant literature in PubMed, EMBASE, and Cochrane, extracting relevant data from the searched literature. The main items extracted were hazard ratios (HRs), risk ratios (RRs) and 95% confidence intervals (CIs). When the HR could not be extracted from the literature, we used Engauge Digitizer software for extraction. Data analysis was accomplished using the Review Manager 5.4 tool.

Results

Our study included seven articles involving 1633 cases of stage II nasopharyngeal cancer. The survival outcomes were overall survival (OS) (HR = 1.03, 95% CI (0.71–1.49), P = 0.87), progression-free survival (PFS) (HR = 0.91, 95% CI (0.59–1.39), P = 0.66), distant metastasis-free survival (DMFS) (HR = 1.05, 95% CI (0.57–1.93), P = 0.87), local recurrence-free survival (LRFS) (HR = 0.87, 95% CI (0.41–1.84), P = 0.71, P > 0.05), and locoregional failure-free survival (LFFS) (HR = 1.18, 95% CI (0.52–2.70), P = 0.69).

Conclusions

In the era of intensity-modulated radiotherapy, concurrent chemoradiotherapy and radiotherapy alone have the same survival benefits, and concurrent chemoradiotherapy increases acute hematological toxicity. Subgroup analysis showed that for people with N1 nasopharyngeal cancer at risk of distant metastases, concurrent chemoradiotherapy and radiotherapy alone also had equal survival benefits.

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Data availability

Data are stored in an institutional repository and will be shared upon request to the corresponding author.

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Acknowledgements

Thanks to the “Ten Thousand Plan” Youth Talent Project in Yunnan Province.

Funding

This work was supported by “Ten Thousand Plan” Youth Talent Project.

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Author notes

    Authors and Affiliations

    1. Department of Radiotherapy, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, 519 Kunzhou Road, Kunming, Yunnan, China

      Yongyuan Xue, Tianrui Xu, Zhengfei Li, Lixiu Zhu, Xin Li & Wei Xiong

    2. Department of Head and Neck Surgery Section II, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, 519 Kunzhou Road, Kunming, Yunnan, China

      Guoping Li & Tao Xie

    3. Department of Head and Neck Surgery Section I, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, 519 Kunzhou Road, Kunming, Yunnan, China

      Hongyang Xu

    4. Department of Ultrasound, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, 519 Kunzhou Road, Kunming, Yunnan, China

      Zhiyao Li

    Author notes

    1. Yongyuan Xue, Guoping Li, Tao Xie, Hongyang Xu are contributed equally to this work.

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      Xue, Y., Li, G., Xie, T. et al. Concurrent chemoradiotherapy versus radiotherapy alone for stage II nasopharyngeal carcinoma in the era of intensity-modulated radiotherapy. Eur Arch Otorhinolaryngol 280, 3097–3106 (2023). https://doi.org/10.1007/s00405-023-07943-9

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