Nimotuzumab combined with concurrent chemoradiotherapy benefits patients with advanced nasopharyngeal carcinoma

Zhanzhan Li,1 Yanyan Li,2 Shipeng Yan,3 Jun Fu,1 Qin Zhou,1 Xinqiong Huang,1 Liangfang Shen1 1Department of Oncology, Xiangya Hospital, Central South University, Changsha, China; 2Department of Nursing, Xiangya Hospital, Central South University, Changsha, China; 3Office of Tumor Prevention and Control, Hunan Provincial Tumor Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China Background: The potential benefits and possible risks associated with combined nimotuzumab and concurrent chemoradiotherapy in patients with advanced nasopharyngeal carcinoma (NPC) have yet to be determined.Methods: The databases PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang were systematically searched through February 2017 for studies comparing combined nimotuzumab and chemoradiotherapy versus chemoradiotherapy alone in the treatment of NPC. Primary outcomes were complete and partial responses, and the secondary outcome was adverse reactions. The random-effect model was used to pool relative risks (RRs) and 95% confidence intervals (CIs).Results: Nine randomized control trials and six cohort studies were included in the final analysis (n=1,015 patients). Compared with chemoradiotherapy alone, chemoradiotherapy combined with nimotuzumab was associated with an increased response rate (RR =1.11, 95% CI: 1.01–1.22). Combined treatment further reduced the occurrence rate of erythropenia (RR =0.11, 95% CI: 0.05–0.28) and neutropenia (RR =0.12, 95% CI: 0.05–0.27). The differences in the rates of other complications were not significant.Conclusion: Nimotuzumab combined with concurrent chemoradiotherapy is more effective in patients with advanced NPC than chemoradiotherapy alone. Patients receiving combination therapy did not have a higher rate of adverse reactions. Nimotuzumab can thus be recommended as an adjunct therapy in patients with advanced NPC.Keywords: randomized controlled trial, cohort studies, nasopharyngeal carcinoma, relative risk, radiotherapy, chemoradiotherap