Induction Chemotherapy with Cisplatin and Fluorouracil alone or with Taxanes for Locally Advanced Squamous-Cell Cancer of the Head and Neck: A Meta-Analysis

Objective To compare the antitumor activity and toxicity of two induction chemotherapy treatments of Taxanes, Cisplatin and Fuorouracil （TPF） versus Cisplatin and Fluorouracil （PF） in locally advanced squamous-cell cancer of the head and neck through a meta-analysis. Methods All previously published and some unpublished studies were performed with a comprehensive search of the literatures included in MEDLINE, EMBASE, Cochrane Library, CBM, etc. The meta-analysis included all randomized controlled trials（RCTs） to compare induction chemotherapy treatments of TPF as experiment group, with PF as control group, in locally advanced squamous-cell cancer of the head and neck. The meta-analysis was based on overall survival（OS）, progression-free survival（PFS）, complete remission（CR） rate, objective remission（OR） rate and toxicity. Results Four RCTs identified by two reviewers were included. There was a significant improvement for the TPF group in OS（HR=0.76, P=0.000 1）, PFS（HR=0.73, P<0.000 01）, CR rate （RR=1.5, P=0.03） and OR rate（RR=1.2, P<0.000 01）. In terms of toxicity, except that incidence of neutropenia in TPF group was higher than PF group,the other haematological toxicity and gastrointestinal toxicity were the same between two groups, or TPF group was lower than PF group. Conclusion Current available evidence shows that both efficacy and safety of induction chemotherapy of TPF are superior to PF and the former one could be a first-line choice for the induction chemotherapy treatment in locally advanced squamous-cell cancer of the head and neck.