A Bayesian network meta-analysis of the primary definitive therapies for locoregionally advanced nasopharyngeal carcinoma: IC+CCRT, CCRT+AC, and CCRT alone

Zhan-Jie Zhang; Liang-Liang Shi; Xiao-Hua Hong; Bo-Ya Xiao; Guo-He Lin; Quentin Liu; Bi-Cheng Wang

doi:10.1371/journal.pone.0265551

A Bayesian network meta-analysis of the primary definitive therapies for locoregionally advanced nasopharyngeal carcinoma: IC+CCRT, CCRT+AC, and CCRT alone

PLoS One. 2022 Mar 18;17(3):e0265551. doi: 10.1371/journal.pone.0265551. eCollection 2022.

Authors

Zhan-Jie Zhang¹, Liang-Liang Shi¹, Xiao-Hua Hong¹, Bo-Ya Xiao², Guo-He Lin³, Quentin Liu⁴, Bi-Cheng Wang¹

Affiliations

¹ Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
³ Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
⁴ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou, China.

Abstract

Background: The major aim of this Bayesian network analysis was to determine the optimal treatment strategy for locoregionally advanced nasopharyngeal carcinoma (LANPC).

Method: We systematically searched databases and extracted data from randomized clinical trials involving LANPC patients randomly assigned to receive induction chemotherapy followed by concurrent chemoradiotherapy (IC+CCRT), CCRT followed by adjuvant chemotherapy (CCRT+AC), or CCRT.

Results: In the network analysis, IC+CCRT was significantly better than CCRT alone for 5-year FFS (odds ratio [OR]: 1.63, 95% credible interval [CrI] 1.16-2.29), DMFS (OR: 1.56, 95% CrI 1.08-2.22), and LFRS (OR: 1.62, 95% CrI 1.02-2.59), but not OS (OR: 1.35, 95% CrI 0.92-2.00). Rank probabilities showed that IC+CCRT was ranked the best followed by CCRT+AC and CCRT for all 5-year outcomes. Although compared to IC+CCRT and CCRT, CCRT+AC did not significantly improve survival but had the highest 5-year survival rates.

Conclusions: IC+CCRT could be recommended as a front-preferred primary definitive therapy for patients with LANPC.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Bayes Theorem
Chemoradiotherapy
Humans
Induction Chemotherapy
Nasopharyngeal Carcinoma / therapy
Nasopharyngeal Neoplasms* / pathology
Network Meta-Analysis

Grants and funding

This study was supported by the Hubei Provincial Natural Science Foundation (Grant number: 2020CFB397 to Bi-Cheng Wang) and the Independent Innovation Foundation of Wuhan Union Hospital (Grant number: 2019-109 to Bi-Cheng Wang). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.