Cetuximab or Nimotuzumab Versus Cisplatin Concurrent with Radiotherapy for Local-Regionally Advanced Nasopharyngeal Carcinoma: a Meta-analysis

Document Type: Research Articles

Authors

1 Department of Radiation Oncology, The Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 He Di Road, Nanning 530021, P.R. China.

2 Department of Medical Oncology, The Affiliated Tumor Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 He Di Road, Nanning 530021, P.R. China.

Abstract

Background: It is unclear whether Cetuximab (CTX) or Nimotuzumab (NTZ) concurrent with radiotherapy delivers
equivalent or improved results with fewer toxicities over standard cisplatin (CDDP) concurrent with radiotherapy
in locally advanced nasopharyngeal carcinoma (NPC). Methods: The strategy involved searching the PubMed,
Embase, Cochrane Library, China National Knowledge Internet Web, Wanfang and Chinese Biomedical databases.
Controlled clinical trials that compared concurrent CTX/NTZ with radiotherapy versus CDDP with radiotherapy
in local-regionally advanced NPC were included. Results: In all, 1,239 patients in six clinical trials were included
in the analysis. The hazard ratios (HRs) between the CTX/NTZ and CDDP groups were 1.01 (95% confidence interval
(CI) 0.63-1.64), 1.06 (95% CI 0.50-2.25), 1.04 (95% CI 0.61-1.76), and 1.05 (95% CI 0.73-1.50) for overall survival,
local-regional failure-free survival, distant metastasis failure-free survival, and disease-free survival, respectively.
Significant differences were found in the incidences of grade 3-4 anaemia [Risk ratio (RR) 0.11 95% CI 0.02-0.58], grade
3-4 neutropenia (RR 0.23 95% CI 0.12- 0.44), grade 3-4 thrombocytopenia (RR 0.31 95% CI 0.12- 0.79), and grade
3-4 vomiting (RR 0.04 95% CI 0.00-0.29) in favour of the CTX/NTZ group. However, the patients in the CTX/NTZ
group experienced a higher incidence of grade 3-4 skin rash (RR 6.45 95% CI 3.84-10.84). Conclusions: Regarding
the efficacy and side effects, the combination of CTX / NTZ and radiotherapy may be an alterative treatment regimen
of standard CDDP concurrent with radiotherapy in local-regionally advanced NPC, especially in patients who cannot
tolerate or who refuse chemotherapy.

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