比较每周顺铂与三周顺铂联合放疗治疗局部晚期头颈癌的疗效和安全性:系统评价和荟萃分析

Mohammed Amine Saâd , Imad Taleb , Sofia El Omri , Hamadoun Traoré , Imane Chahbounia , Choukri Elm'hadi , Saïda Lamine , Mohammed Anouar Mokhlis , Lamia Aalaoui , Mohamed Reda Khmamouche , Khaoula Alaoui Slimani , Yassir Sbitti , Tarik Mahfoud , Hassan Errihani , Mohamed Ichou , Rachid Tanz
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引用次数: 0

摘要

背景:以顺铂为基础的化疗广泛应用于局部晚期头颈癌(HNC)的治疗。最佳的给药方案是每周一次还是三次,一直是争论的主题。本研究旨在评估每周一次与三次顺铂治疗方案在该患者群体中的有效性和安全性。材料和方法根据PRISMA指南,我们进行了这项荟萃分析,比较每周一次和三每周一次顺铂治疗方案的相关结果。研究终点包括总生存期(OS)、无进展生存期(PFS)、无远处转移生存期(DMFS)、局部无复发生存期(LRRFS)和安全性。该荟萃分析方案已在PROSPERO注册(CRD42023461292)。结果2年、3年和5年(2年LRRFS除外)的OS、PFS、LRRFS和DMFS在生存结局分析方面无差异。2年OS的比值比为1.02 (p = 0.87), 3年0.90 (p = 0.46)和5年1.13 (p = 0.59), OR 2年PFS的比值比为0.97 (p = 0.85), 3年0.87 (p = 0.30)和5年0.86 (p = 0.55)。在短期LRRFS(2年)方面,三周顺铂优于周顺铂,OR为1.57 (p = 0.02)。两种方案在不良事件方面相似。结论:除了短期LRRFS(2年)外,每周一次和三每周一次顺铂治疗在头颈癌患者中显示出相当的生存结果和安全性。这些发现表明,治疗决定应根据患者的个人情况,包括合并症和耐受性量身定制。未来的研究应探索累积剂量和生物标志物,以进一步完善治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing efficacy and safety of weekly vs. triweekly cisplatin concurrently with radiotherapy for locally advanced head and neck cancer: Systematic review and meta-analysis

Background

Cisplatin-based chemotherapy is widely used in the treatment of locally advanced head and neck cancer (HNC). The optimal dosing schedule, whether weekly or triweekly, has been a subject of debate. This study aims to evaluate the efficacy and safety of weekly versus triweekly cisplatin regimens in this patient population.

Material and methods

In accordance with the PRISMA guidelines, we conducted this meta-analysis to compare outcomes associated with weekly and triweekly cisplatin regimens. The endpoints examined were overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), locoregional recurrence-free survival (LRRFS) and safety. This meta-analysis protocol was registered in PROSPERO (CRD42023461292).

Results

The analysis of survival outcomes demonstrated no difference between the two schedules in terms of OS, PFS, LRRFS and DMFS at 2 and 3 years and 5 years (except for 2 years LRRFS). The odds ratio of OS at 2 years was 1.02 (p = 0.87) at 3 years 0.90 (p = 0.46) and at 5 years 1.13 (p = 0.59), and for PFS at the OR 2 years was 0.97 (p = 0.85) at 3 years 0.87 (p = 0.30) and at 5 years 0.86 (p = 0.55). Triweekly was superior to weekly cisplatin in terms of short-term LRRFS (at 2 years), with an OR of 1.57 (p = 0.02). Both protocols were similar in terms of adverse events.

Conclusion

Both weekly and triweekly cisplatin regimens show comparable survival outcomes and safety profiles in patients with head and neck cancers, except for short term LRRFS (at 2 years). These findings suggest that treatment decisions should be tailored to the patient's individual profile, including comorbidities and tolerability. Future studies should explore cumulative dosing and biomarkers to refine treatment strategies further.
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