Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis
Objectives: Postoperative chemoradiotherapy has arisen as an adjuvant option for head and neck cancers, but its superiority to radiotherapy alone in patients with adverse pathologic factors is not yet well defined. We aimed to perform an updated meta-analysis comparing outcomes in head and neck canc...
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Elsevier
2025-01-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869424001319 |
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| author | Gabriela Garcia Korczaguin Gilberto Vaz Teixeira Ashok Shaha |
| author_facet | Gabriela Garcia Korczaguin Gilberto Vaz Teixeira Ashok Shaha |
| author_sort | Gabriela Garcia Korczaguin |
| collection | DOAJ |
| description | Objectives: Postoperative chemoradiotherapy has arisen as an adjuvant option for head and neck cancers, but its superiority to radiotherapy alone in patients with adverse pathologic factors is not yet well defined. We aimed to perform an updated meta-analysis comparing outcomes in head and neck cancer patients with adverse pathologic factors who underwent postoperative chemoradiotherapy and radiotherapy alone. Methods: We systematically searched PubMed, Scopus and the Cochrane Central Register of Controlled Trials for Randomised Controlled Trials (RCTs) in patients submitted to postoperative adjuvant therapy with radiotherapy alone or chemoradiotherapy. Results: We included 8 studies with a total of 2376 patients, of whom 1183 (49.8%) underwent postoperative chemoradiotherapy. In pooled analysis, overall survival (HR = 0.86; 95% CI 0.76‒0.98; p = 0.64; I2 = 0%) and disease-free survival (HR = 0.85; 95% CI 0.75‒0.96; p = 0.64; I2 = 0%) were shown to be superior in patients undergoing combined therapy. Chemoradiotherapy was also associated with significantly lower locoregional recurrence. However, there was no significant difference in distant metastasis occurrence between both groups. In an analysis of the extracapsular extension subgroup, the overall survival (OR = 3.12; 95% CI 1.76–5.51; p = 0.78; I2 = 0%), disease-free survival (OR = 3.44; 95% CI 2.00‒5.91; p = 0.68; I2 = 0%), and locoregional control (OR = 1.86; 95% CI 1.16‒2.99; p = 0.98; I2 = 0%) were better in the postoperative adjuvant chemoradiotherapy branch over radiotherapy alone. Conclusion: The results of our meta-analysis suggest that postoperative adjuvant chemoradiotherapy in patients with head and neck cancer with adverse pathologic factors favors a superior survival and a better locoregional control compared to postoperative radiotherapy alone, despite not affecting the ocurrence of distant metastasis. |
| format | Article |
| id | doaj-art-e58041934c984d39a830290b2736c5bf |
| institution | OA Journals |
| issn | 1808-8694 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj-art-e58041934c984d39a830290b2736c5bf2025-08-20T01:47:25ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942025-01-0191110151610.1016/j.bjorl.2024.101516Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysisGabriela Garcia Korczaguin0Gilberto Vaz Teixeira1Ashok Shaha2Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil; Corresponding author.Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil; Centro de Pesquisas Oncológicas (CEPON), Serviço de Cabeça e Pescoço, Florianópolis, SC, BrazilMemorial Sloan-Kettering Cancer Center, Head and Neck Service, New York, USA; Cornell University Medical College, New York, USAObjectives: Postoperative chemoradiotherapy has arisen as an adjuvant option for head and neck cancers, but its superiority to radiotherapy alone in patients with adverse pathologic factors is not yet well defined. We aimed to perform an updated meta-analysis comparing outcomes in head and neck cancer patients with adverse pathologic factors who underwent postoperative chemoradiotherapy and radiotherapy alone. Methods: We systematically searched PubMed, Scopus and the Cochrane Central Register of Controlled Trials for Randomised Controlled Trials (RCTs) in patients submitted to postoperative adjuvant therapy with radiotherapy alone or chemoradiotherapy. Results: We included 8 studies with a total of 2376 patients, of whom 1183 (49.8%) underwent postoperative chemoradiotherapy. In pooled analysis, overall survival (HR = 0.86; 95% CI 0.76‒0.98; p = 0.64; I2 = 0%) and disease-free survival (HR = 0.85; 95% CI 0.75‒0.96; p = 0.64; I2 = 0%) were shown to be superior in patients undergoing combined therapy. Chemoradiotherapy was also associated with significantly lower locoregional recurrence. However, there was no significant difference in distant metastasis occurrence between both groups. In an analysis of the extracapsular extension subgroup, the overall survival (OR = 3.12; 95% CI 1.76–5.51; p = 0.78; I2 = 0%), disease-free survival (OR = 3.44; 95% CI 2.00‒5.91; p = 0.68; I2 = 0%), and locoregional control (OR = 1.86; 95% CI 1.16‒2.99; p = 0.98; I2 = 0%) were better in the postoperative adjuvant chemoradiotherapy branch over radiotherapy alone. Conclusion: The results of our meta-analysis suggest that postoperative adjuvant chemoradiotherapy in patients with head and neck cancer with adverse pathologic factors favors a superior survival and a better locoregional control compared to postoperative radiotherapy alone, despite not affecting the ocurrence of distant metastasis.http://www.sciencedirect.com/science/article/pii/S1808869424001319Head and neck squamous cell carcinomaAdjuvant therapyChemoradiotherapyRadiotherapyMeta-analysis |
| spellingShingle | Gabriela Garcia Korczaguin Gilberto Vaz Teixeira Ashok Shaha Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis Brazilian Journal of Otorhinolaryngology Head and neck squamous cell carcinoma Adjuvant therapy Chemoradiotherapy Radiotherapy Meta-analysis |
| title | Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis |
| title_full | Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis |
| title_fullStr | Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis |
| title_full_unstemmed | Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis |
| title_short | Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis |
| title_sort | postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology a systematic review and meta analysis |
| topic | Head and neck squamous cell carcinoma Adjuvant therapy Chemoradiotherapy Radiotherapy Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1808869424001319 |
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