Meta-analysis of chemotherapy in nasopharyngeal carcinoma (MAC-NPC): An update on 4,798 patients.

6022 Background: In a previous MAC-NPC individual patient data (IPD) meta-analysis, the addition of chemotherapy (CT) to radiotherapy improved overall survival (OS) in nasopharyngeal carcinoma (NPC; Baujat IJROBP 2006). There was an interaction between the timing of CT and treatment effect, with an OS benefit restricted to the concomitant (+/- adjuvant) timing. Since other trials have been conducted, this meta-analysis was updated. Methods: Trials of radiotherapy (RT) with or without CT in patients with non-metastatic NPC were identified and updated IPD obtained. Both Western and Chinese medical literatures were searched. OS was the main endpoint. The fixed-effect model was used. All analyses were pre-specified. Results: Overall 19 trials and 4,798 pts were included. One 2x2 trial was counted twice and 5,020 pts were analyzed. Patients characteristics were well balanced (60% < 50 years, 75% male, 60% PS 0, 90% stage III-IV and 96% WHO grade 2-3). Median follow-up was 7.1 years. There was a significant ben...