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295

ICAR SINONASAL TUMORS

TABLE XXV.7 Evidence surrounding induction chemotherapy in NPC treatment.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Liuet al. 1692

1. IC + CRT improved OS, LRRFS, and DMFS, and had a trend toward better CR rates compared with CRT group, but with more grade 3–4 AEs 2. GP group had the most favorable OS benefit and longer DMFS and manageable AEs 3. TPF provided the first exact probability of efficacy in LRFS, ranking second in OS, and with highest rates of grade 3 or above AEs 1. IC + CRT group seemed to have better long-term QOL outcomes compared with CRT alone 2. Subgroup analysis showed the 1. No significant difference in OS or PFS between TPF versus PF groups 2. Increased frequencies of grade 3 or 4 neutropenia, anemia, and thrombocytopenia in TPF group versus PF group 1. Significant increase in 5-year OS in IC + CRT group than in the CRTgroup 2. Significant increase in 5-year FFS in IC + CRT group versus CRT alone group, DMFS, and LRFS 3. High complete response rate in 16 weeks after the end of RT was observed in both groups with no significant difference 4. FFS benefits were primarily observed in patients with N1 disease, stage IVA, pretreatment LDH ≥ 170 U/l, or pretreatment plasma EBV DNA ≥ 6000 copies/mL 5. Significantly higher rate of grade 3 or 4 AEs during the entire treatment course in IC + CRT group versus CRT alone group; no significant difference in late toxicities between groups better QOL outcomes are significant in 2DRT group

1. OS 2. LRFS, DMFS, CR 3. Grade 3 or 4 AE

2022 1

Network meta analysis

2496 patients from seven RCTs who

received IC + CRT

Yanget al. 1693

2021

2

Phase III RCT 228 patients with stage III to IVB (except T3N0)NPC IC + CRTvs CRTalone

1. EORTC

QLQ-C30

2. EORTC

QLQ-H&N35

Jinet al. 1690

1. PFS 2. LC, OS, AEs

276 patients with stage III or IV NPC (AJCC 2009) of WHO types II/III TPF + CRTversus PF + CRT 480 patients with stage III-IVB (except T3-4N0) NPC from 10 institutions IC + CRT versus CRT alone

2019 2

Multicenter open-label

randomized noninferior ity trial

Sunet al. 1687 Li et al. 1758

2016,

updated 2019 2

Open-label, phase III,

1. FFS 2. OS, DMFS, LRFS, and

multicenter RCT

response rates

3. Toxicities

(Continues)