Locally advanced head and neck squamous cell carcinoma treatment efficacy and safety: a systematic review and network meta-analysis

Huanhuan Wang; Zhuangzhuang Zheng; Yangyu Zhang; Chenbin Bian; Jindian Bao; Ying Xin; Xin Jiang

doi:10.3389/fphar.2023.1269863

Locally advanced head and neck squamous cell carcinoma treatment efficacy and safety: a systematic review and network meta-analysis

Front Pharmacol. 2023 Sep 19:14:1269863. doi: 10.3389/fphar.2023.1269863. eCollection 2023.

Authors

Huanhuan Wang^{1

2}, Zhuangzhuang Zheng^{1

2}, Yangyu Zhang³, Chenbin Bian^{1

2}, Jindian Bao^{1

2}, Ying Xin^{4

5}, Xin Jiang^{1

2}

Affiliations

¹ Jilin Provincial Key Laboratory of Radiation Oncology and Therapy, The First Hospital of Jilin University, Changchun, China.
² NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China.
³ Division of Clinical Research, The First Hospital of Jilin University, Changchun, China.
⁴ Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China.
⁵ College of Basic Medical Sciences, Jilin University, Changchun, China.

Abstract

Head and neck squamous cell carcinoma (HNSCC) accounts for approximately 3% of new cancer cases and 3% of all deaths worldwide. Most HNSCC patients are locally advanced (LA) at diagnosis. The combination of radiotherapy (RT), chemotherapy, targeted therapy, and immunotherapy are the primary LA-HNSCC treatment options. Nevertheless, the choice of optimal LA-HNSCC treatment remains controversial. We systematically searched public databases for LA-HNSCC-related studies and assess treatment effectiveness and safety by assessing the objective response rate (ORR), ≥3 adverse events (AEs), overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), local-region control (LRC), and disease-specific survival (DSS). 126 randomized controlled clinical trials (RCTs) were included in this study. We show that concurrent RT with nimotuzumab or conventional concurrent chemo-radiotherapy (CCRT) had significantly better efficacy and long-term survival without increasing AEs than RT alone. Accelerated fractionated radiotherapy (AFRT) showed better efficiency than conventional fractionated RT, although it had higher AEs. In addition, concurrent cetuximab combined with RT failed to show a significant advantage over RT alone. Trial registration: PROSPERO CRD42022352127.

Keywords: accelerated fractionated radiotherapy; concurrent chemo-radiotherapy; locally advanced head and neck squamous cell carcinoma; meta-analysis; radiotherapy.

Publication types

Review

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Jilin Provincial Science and Technology Foundations (20210509003RQ and 20210402002GH), the Health Talents Special Project of the Jilin Provincial Finance Department (JLSWSRCZX 2021-065), the program of Changchun Science and Technology Development Plan (21ZY29), and the Achievement Transformation Guiding Foundation of the First Hospital of Jilin University (CGZHYD202012-029).