• Medicine · Jan 2025

    Meta Analysis Comparative Study

    Comparison of TPF and PF induction chemotherapy combined with cisplatin concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: A systematic review and meta-analysis.

    • Haiwen Li, Qibiao Wu, Haiqing Luo, Jiayuan Wu, Wenmei Su, and Lili Yu.
    • Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, P.R. China.
    • Medicine (Baltimore). 2025 Jan 17; 104 (3): e41278e41278.

    BackgroundThe standard of care for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) is induction chemotherapy (ICT) followed by concurrent chemoradiation (CCRT). However, the ideal ICT regimen for LA-NPC remains unclear. We conducted a meta-analysis to evaluate the survival outcomes, responses, and incidences of toxicities between taxane, cisplatin and fluorouracil (TPF) and cisplatin and fluorouracil (PF) ICT regimens plus CCRT in LA-NPC.MethodsA systematic review and meta-analysis of the literature was conducted to compare the efficacy and safety of TPF versus PF followed by CCRT with cisplatin every 3 weeks or weekly cisplatin and intensity-modulated radiotherapy in LA-NPC.ResultsThree studies with 2482 patients met the inclusion criteria. ICT with the TPF regimen plus CCRT resulted in a significantly improved progression-free survival (hazard ratios [HR] 0.84 [95% CI 0.73-0.96], P = .01), overall survival (HR 0.83 [95% CI 0.71-0.97], P = .02), and 3-year locoregional recurrence-free survival (risk ratios [RR] 1.03 [95% CI 1.01-1.06], P = .009) compared with the PF regimen plus CCRT in LA-NPC. However, distant metastasis-free survival was not statistically significant (P = .07). The incidence of grade 3 or 4 neutropenia (RR 2.08 [95% CI 1.84-2.36]) and diarrhea (RR 1.94 [95% CI 1.07-3.52]) during ICT was higher in the TPF group than in the PF group.ConclusionsIn terms of progression-free survival, overall survival, locoregional recurrence-free survival, in the era of intensity-modulated radiotherapy, the TPF plus CCRT with cisplatin is superior to PF plus CCRT with cisplatin in LA-NPC. Thus, the TPF plus CCRT regimen appears to be a reasonable treatment option, and further confirmation by prospective studies is needed.Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.

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