The best choice of induction chemotherapy for patients with locally advanced nasopharyngeal carcinoma: Bayesian network meta-analysis.

Abstract

The determination of the optimal induction chemotherapy (IC) regimen for patients with locally advanced nasopharyngeal carcinoma (NPC) remains controversial. Eligible trials included in this Bayesian network meta-analysis were judged by synthetically evaluating survival and safety outcomes. The analysis revealed that the combined IC regimen of gemcitabine plus cisplatin (GP) gained not only the most favorable overall survival (OS) benefit but also longer distant metastasis-free survival and manageable adverse events (AEs). Additionally, combination IC regimen of mitomycin, epirubicin, cisplatin, fluorouracil, and leucovorin had insufficient significant efficacy on complete response. Docetaxel combined with cisplatin and fluorouracil induction regimen provided the first exact probability of efficacy in term of local recurrence-free survival, ranking second in OS, but accompanied by the highest rates of grade 3 or above AEs. GP regimen appears to be currently the best choice of IC regimen for combined benefit of patients with locally advanced NPC.