Low-Compared with High-Dose Regimen of Induction Chemotherapy in Locally Advanced Nasopharyngeal Cancer: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Abstract International recommendation supports induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) as a new standard of care for locally advanced nasopharyngeal cancer (LA-NPC) which give a survival benefit. TPF is one of the IC regimens which consists of docetaxel (75 mg/m2, 1 hour infusion), cisplatin (75 mg/m2, 0.5–3 hours), and 5-fluorouracil (600 mg/m2, 4 days). Previous retrospective study in Chinese population reported low-dose TPF (L-TPF), consists of docetaxel (60 mg/m2), cisplatin (65 mg/m2), and then 5-fluorouracil (550 mg/m2/d; 5 days), showed better tolerance and compliance rates, with similar efficacy to high-dose TPF (H-TPF). Thus, we aim to evaluate the current evidence of the effect of L-TPF compared with H-TPF on survival and tolerance as IC in LA-NPC. Data were collected from PubMed, PubMed Central, and Science Direct, using combinations of keywords related to neoadjuvant chemotherapy (NAC) or IC, TPF dose regimen, and LA-NPC. The included studies investigated the efficacy and toxicity of IC with a TPF regimen. The quality of each included study was assessed using the Newcastle–Ottawa scale for cohort studies and the JADAD scale for randomized controlled trial (RCT). Only moderate- and good-quality studies were further evaluated in the meta-analysis. A total of six studies consisting of 509 NAC patients were included. All the studies evaluated overall survival (OS) and progression-free survival (PFS). Quantitative analysis showed that L-TPF + CCRT significantly showed good OS (hazard ratio [HR] = 0.50; 95% confidence interval [CI], 0.33–0.76; p = 0.001) but not PFS (HR = 0.45; 95% CI, 0.16–1.25; p = 0.13). Common chemotoxicities that were found in both groups were neutropenia and anemia. L-TPF IC had a significant positive effect on the survival of LA-NPC patients. Further, larger multicenter RCT studies are needed to focus on evaluating the optimal TPF regimen dose in LA-NPC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.015 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".