ArticleClinical and translational radiation oncology2022
Meta-analysis of chemotherapy in nasopharynx carcinoma (MAC-NPC): An update on 26 trials and 7080 patients.
Article in Clinical and translational radiation oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Trial
- Survival and patterns of recurrence in patients with nasopharyngeal carcinoma from a non-endemic region-A German multicenter analysis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Should standard concurrent chemoradiotherapy remain the preferred treatment for elderly patients with locoregionally advanced nasopharyngeal carcinoma?Radiation oncology (London, England) · 2026Article
- [European journal of nuclear medicine and molecular imaging · 2026Article
- Indirect comparison of TPF and GP induction chemotherapy regimens in nasopharyngeal carcinoma: a data-driven reassessment before the transition to induction chemoimmunotherapy.The oncologist · 2025Article
- Nasopharyngeal necrosis following intensity-modulated radiation therapy of primary nasopharyngeal carcinoma-incidence rate and predictors of risk.BMC cancer · 2025Article
- Effect and safety of immunotherapy among elder patients (age ≥ 65) with recurrent or metastatic nasopharyngeal carcinoma.BMC cancer · 2025Article
- Clinical Outcomes for Nasopharyngeal Cancer in Non-Asian Patients: A Single-Center Experience.Journal of clinical medicine · 2025Article
- A Nomogram Based on Tumor Response to Induction Chemotherapy and Plasma Epstein-Barr Virus DNA Level after Induction Chemotherapy to Explore Individualized Treatment of Patients with Locally Advanced Nasopharyngeal Carcinoma.Journal of inflammation research · 2025Article
- Evaluating the Efficacy of Different Treatment Intensities in Nasopharyngeal Carcinoma Patients: A Nationwide Cancer Registry-Based Study.Annals of surgical oncology · 2024Article
- Analysis of patients with parotid recurrence after parotid-sparing IMRT for nasopharyngeal carcinoma: case series and review of the literature.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Review
- ASO Author Reflections: Evaluating Treatment Intensities in Nasopharyngeal Carcinoma-Insights from Real-World Evidence.Annals of surgical oncology · 2024Article
- Lobaplatin-based concurrent chemoradiotherapy in elderly nasopharyngeal carcinoma.Annals of medicine · 2024Article
- [Role of chemotherapy in radiotherapy-treated nasopharynx carcinoma: update of the MAC-NPC network meta-analysis].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Extracapsular nodal extension and tumor deposits in head and neck squamous cell carcinoma.Cancer reports (Hoboken, N.J.) · 2023Observational
- Taxonomy and anticancer potential of Streptomyces niphimycinicus sp. nov. against nasopharyngeal carcinoma cells.Applied microbiology and biotechnology · 2023Article
- Early Stage and Locally Advanced Nasopharyngeal Carcinoma Treatment from Present to Future: Where Are We and Where Are We Going?Current treatment options in oncology · 2023Review
- Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas.Pharmaceutics · 2023Review
- The Clinical Characteristics and Outcomes of Human Papillomavirus-Positive Nasopharyngeal Carcinoma in a Single-Institution Cohort.Journal of clinical medicine · 2023Article
- Management of Older Patients with Head and Neck Cancer: A Comprehensive Review.Advances in therapy · 2023Review
Corrections and comments
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Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeChemotherapy, when added to radiotherapy, improves survival in locally advanced nasopharyngeal carcinoma (NPC). This article presents the second update of the Meta-Analysis of Chemotherapy in NPC.
methodsPublished or unpublished randomized trials assessing radiotherapy (±a second chemotherapy timing) with/without chemotherapy in non-metastatic NPC patients were identified. Updated data were sought for studies included in the previous rounds of the meta-analysis. The primary endpoint was overall survival. All trials were analyzed following the intent-to-treat principle using a fixed-effects model. Treatments were classified in five subsets according to chemotherapy timing. The statistical analysis plan was pre-specified.
resultsEighteen new trials were identified. Individual patient data were available for seven. In total, the meta-analysis now included 26 trials and 7,080 patients. The addition of chemotherapy reduced the risk of death, with a hazard ratio (HR) of 0.79 (95% confidence interval (CI) [0.73; 0.85]), and an absolute survival increase at 5 and 10 years of 6.1% [+3.9; +8.3] and + 8.4% [+5.7; +11.1], respectively. The largest effect was observed for concomitant + adjuvant, induction (with concomitant in both arms) and concomitant chemotherapy, with respective HR [95%CI] of 0.68 [0.59; 0.79] (absolute survival increase at 5 years: 12.3% (7.0%;17.6%)), 0.73 [0.63; 0.86] (6.0% (2.5%;9.5%)) and 0.81 [0.70; 0.92] (5.2% (0.8%;9.6%)). The benefit of chemotherapy was also demonstrated by improvement in progression-free survival, cancer mortality, locoregional control and distant control. There was a significant interaction between patient age and chemotherapy effect.
conclusionThis updated meta-analysis confirms the benefit of concomitant chemotherapy and concomitant + adjuvant chemotherapy, and suggests that addition of induction or adjuvant chemotherapy to concomitant chemotherapy improves tumor control and survival. The benefit of chemotherapy decreases with increasing patient age.
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