Nimotuzumab combined with concurrent chemoradiotherapy benefits patients with advanced nasopharyngeal carcinoma

Abstract

Background

The potential benefits and possible risks associated with combined nimotuzumab and concurrent chemoradiotherapy in patients with advanced nasopharyngeal carcinoma (NPC) have yet to be determined.

Methods

The databases PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang were systematically searched through February 2017 for studies comparing combined nimotuzumab and chemoradiotherapy versus chemoradiotherapy alone in the treatment of NPC. Primary outcomes were complete and partial responses, and the secondary outcome was adverse reactions. The random-effect model was used to pool relative risks (RRs) and 95% confidence intervals (CIs).

Results

Nine randomized control trials and six cohort studies were included in the final analysis (n=1,015 patients). Compared with chemoradiotherapy alone, chemoradiotherapy combined with nimotuzumab was associated with an increased response rate (RR =1.11, 95% CI: 1.01–1.22). Combined treatment further reduced the occurrence rate of erythropenia (RR =0.11, 95% CI: 0.05–0.28) and neutropenia (RR =0.12, 95% CI: 0.05–0.27). The differences in the rates of other complications were not significant.

Conclusion

Nimotuzumab combined with concurrent chemoradiotherapy is more effective in patients with advanced NPC than chemoradiotherapy alone. Patients receiving combination therapy did not have a higher rate of adverse reactions. Nimotuzumab can thus be recommended as an adjunct therapy in patients with advanced NPC.

Keywords:

• randomized controlled trial
• cohort studies
• nasopharyngeal carcinoma
• relative risk
• radiotherapy
• chemoradiotherapy

Supplementary materials

Figure S1 PRISMA checklist.

Notes: Reproduced from Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(6):e1000097.¹⁰ For more information, visit: www.prisma-statement.org.

Figure S2 Risk of bias and applicability concerns graph: review authors’ judgments about each domain presented as percentages across included studies.

Figure S3 Risk of bias and applicability concerns summary: review authors’ judgments about each domain for each included study.

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Acknowledgments

The authors thank all their colleagues working in the Department of Oncology, Xiangya Hospital, Central South University. This research was funded by National Natural Science Foundation (81602683) and Hunan Provincial Natural Science Foundation (2015JJ4055).

Disclosure

The authors report no conflicts of interest in this work.