J Cancer 2021; 12(20):6209-6215. doi:10.7150/jca.62188 This issue

Research Paper

Weekly versus triweekly cisplatin-based concurrent chemoradiotherapy for nasopharyngeal carcinoma: a systematic review and pooled analysis

Jie Tang1#, Guo-Rong Zou1#, Xiu-Wen Li2#, Zhen Su1, Xiao-Long Cao1, Bi-Cheng Wang3✉

1. Department of Oncology, Panyu Central Hospital, Cancer Institute of Panyu, Guangzhou 511400, China.
2. Department of Cardiology, Panyu Central Hospital, Guangzhou 511400, China.
3. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
#These authors contributed equally to this study.

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Citation:
Tang J, Zou GR, Li XW, Su Z, Cao XL, Wang BC. Weekly versus triweekly cisplatin-based concurrent chemoradiotherapy for nasopharyngeal carcinoma: a systematic review and pooled analysis. J Cancer 2021; 12(20):6209-6215. doi:10.7150/jca.62188. Available from https://www.jcancer.org/v12p6209.htm

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Abstract

Graphic abstract

Background: Weekly and triweekly cisplatin-based concurrent chemoradiotherapy (CCRT) have been used in the treatment of nasopharyngeal carcinoma (NPC).

Objective: This study aimed to compare the benefits and risks between the two treatments.

Methods: We systematically searched electronic databases for prospective and retrospective clinical studies of NPC patients who received weekly compared with triweekly cisplatin-based CCRT. The primary endpoints comprised overall, failure-free, distant metastasis-free, and locoregional recurrence-free survivals (OS, FFS, DMFS, and LRFS). Secondary endpoints were toxicities.

Results: Six studies were included in the systematic review, of which four with 1515 NPC patients were eligible for further pooled analysis. There were no significant differences between weekly and triweekly groups in terms of 5-year OS (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.51-1.79), FFS (OR 1.09, 95% CI 0.67-1.76), DMFS (OR 1.25, 95% CI 0.54-2.92), and LRFS (OR 0.83, 95% CI 0.55-1.25). For grade ≥ 3 toxicities, the weekly group had higher risks of anemia (risk ratio [RR] 2.96, 95% CI 1.12-7.81) and thrombocytopenia (RR 2.75, 95% CI 1.54-4.90), but a lower incidence of vomiting (RR 0.34, 95% CI 0.18-0.63) versus the triweekly group.

Conclusion and Relevance: Both weekly and triweekly schedules could be recommended to NPC patients during CCRT. Additionally, hematologic adverse events in weekly strategy and non-hematologic adverse events in triweekly strategy are of higher concern.

Keywords: weekly, triweekly, cisplatin, concurrent chemotherapy, nasopharyngeal carcinoma