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Open Access Research article

The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population: a meta-analysis of the phase iii randomized trials

Li Zhang1, Chong Zhao2, Bijesh Ghimire1, Ming-Huang Hong3, Qing Liu3, Yang Zhang3, Ying Guo3*, Yi-Jun Huang4* and Zhong-Zhen Guan1

Author Affiliations

1 Department of Medical Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China

2 Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China

3 Clinical Trials Center, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, 651 Dongfeng Road East, Guangzhou, China

4 Department of Pharmacology, Medical School of Sun Yat-Sen University, Guangzhou, China

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BMC Cancer 2010, 10:558  doi:10.1186/1471-2407-10-558

Published: 15 October 2010

Abstract

Background

The main objective of this meta-analysis was to determine the clinical benefit of concurrent chemoradiotherapy (CCRT) compared with radiation alone (RT) in the treatment of nasopharyngeal carcinoma (NPC) patients in endemic geographic areas.

Methods

Using a prospective meta-analysis protocol, two independent investigators reviewed the publications and extracted the data. Published randomized controlled trials (RCTs) in which patients with NPC in endemic areas were randomly assigned to receive CCRT or RT alone were included.

Results

Seven trials (totally 1608 patients) were eligible. Risk ratios (RRs) of 0.63 (95% CI, 0.50 to 0.80), 0.76 (95% CI, 0.61 to 0.93) and 0.74 (95% CI, 0.62 to 0.89) were observed for 2, 3 and 5 years OS respectively in favor of the CCRT group. The RRs were larger than that detected in the previously reported meta-analyses (including both endemic and non-endemic), indicating that the relative benefit of survival was smaller than what considered before.

Conclusions

This is the first meta-analysis of CCRT vs. RT alone in NPC treatment which included studies only done in endemic area. The results confirmed that CCRT was more beneficial compared with RT alone. However, the relative benefit of CCRT in endemic population might be less than that from previous meta-analyses.