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A Network Meta-Analysis of the Systemic Therapies in Unresectable Head and Neck Squamous Cell Carcinoma

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Title: A Network Meta-Analysis of the Systemic Therapies in Unresectable Head and Neck Squamous Cell Carcinoma
Authors: Jinling Yuan MMed, Kexin Shi MMed, Guanhua Chen MMed, Weilin Xu MMed, Lei Qiu MMed, Yinjiao Fei MMed, Yuchen Zhu MMed, Mengxing Wu MMed, Yurong Li MMed, Xinchen Sun MD, Yuandong Cao MD, Shu Zhou MMD
Source: Cancer Control, Vol 31 (2024)
Publisher Information: SAGE Publishing, 2024.
Publication Year: 2024
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: The current standard treatment for locally advanced squamous cell carcinoma of the head and neck (LASCCHN) comprises concurrent radiotherapy (CRT) alongside platinum-based chemotherapy. However, innovative therapeutic alternatives are being evaluated in phase II/III randomized trials. This study employed a Bayesian network meta-analysis (NMA) using fixed effects to provide both direct and indirect comparisons of all existing treatment modalities for unresectable LASCCHN. Methods: We referenced randomized controlled trials (RCTs) from January 2000 to July 2023 by extensively reviewing PubMed, EMBASE, and Web of Science databases, adhering to the Cochrane methodology. Relevant data, including summary estimates of overall survival (OS) and progression-free survival (PFS), were extracted from these selected studies and recorded in a predefined database sheet. Subsequently, we conducted a random effects network meta-analysis using a Bayesian framework. Results: Based on the Surface Under the Cumulative Ranking (SUCRA) values, the league table organizes the various treatments for OS in the following order: IC + RT&MTT, MTT-CRT, IC + CRT&MTT, CRT, IC + CRT, MTT-RT, IC + MTT-RT, and RT. In a similar order, the treatments rank as follows according to the league table: IC + CRT&MTT, MTT-CRT, IC + CRT, IC + RT&MTT, CRT, IC + MTT-RT, MTT-RT, and RT. Notably, none of these treatments showed significant advantages over concurrent chemoradiotherapy. Conclusion: Despite concurrent chemoradiotherapy being the prevailing treatment for LASCCHN, our findings suggest the potential for improved outcomes when concurrent chemoradiotherapy is combined with targeted therapy or induction chemotherapy.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1526-2359
10732748
Relation: https://doaj.org/toc/1526-2359
DOI: 10.1177/10732748241255535
Access URL: https://doaj.org/article/c9a60a056f6146298d9b1aff76da79f9
Accession Number: edsdoj.9a60a056f6146298d9b1aff76da79f9
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  Data: A Network Meta-Analysis of the Systemic Therapies in Unresectable Head and Neck Squamous Cell Carcinoma
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  Data: <searchLink fieldCode="AR" term="%22Jinling+Yuan+MMed%22">Jinling Yuan MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Kexin+Shi+MMed%22">Kexin Shi MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Guanhua+Chen+MMed%22">Guanhua Chen MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Weilin+Xu+MMed%22">Weilin Xu MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Lei+Qiu+MMed%22">Lei Qiu MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Yinjiao+Fei+MMed%22">Yinjiao Fei MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Yuchen+Zhu+MMed%22">Yuchen Zhu MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Mengxing+Wu+MMed%22">Mengxing Wu MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Yurong+Li+MMed%22">Yurong Li MMed</searchLink><br /><searchLink fieldCode="AR" term="%22Xinchen+Sun+MD%22">Xinchen Sun MD</searchLink><br /><searchLink fieldCode="AR" term="%22Yuandong+Cao+MD%22">Yuandong Cao MD</searchLink><br /><searchLink fieldCode="AR" term="%22Shu+Zhou+MMD%22">Shu Zhou MMD</searchLink>
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  Data: The current standard treatment for locally advanced squamous cell carcinoma of the head and neck (LASCCHN) comprises concurrent radiotherapy (CRT) alongside platinum-based chemotherapy. However, innovative therapeutic alternatives are being evaluated in phase II/III randomized trials. This study employed a Bayesian network meta-analysis (NMA) using fixed effects to provide both direct and indirect comparisons of all existing treatment modalities for unresectable LASCCHN. Methods: We referenced randomized controlled trials (RCTs) from January 2000 to July 2023 by extensively reviewing PubMed, EMBASE, and Web of Science databases, adhering to the Cochrane methodology. Relevant data, including summary estimates of overall survival (OS) and progression-free survival (PFS), were extracted from these selected studies and recorded in a predefined database sheet. Subsequently, we conducted a random effects network meta-analysis using a Bayesian framework. Results: Based on the Surface Under the Cumulative Ranking (SUCRA) values, the league table organizes the various treatments for OS in the following order: IC + RT&MTT, MTT-CRT, IC + CRT&MTT, CRT, IC + CRT, MTT-RT, IC + MTT-RT, and RT. In a similar order, the treatments rank as follows according to the league table: IC + CRT&MTT, MTT-CRT, IC + CRT, IC + RT&MTT, CRT, IC + MTT-RT, MTT-RT, and RT. Notably, none of these treatments showed significant advantages over concurrent chemoradiotherapy. Conclusion: Despite concurrent chemoradiotherapy being the prevailing treatment for LASCCHN, our findings suggest the potential for improved outcomes when concurrent chemoradiotherapy is combined with targeted therapy or induction chemotherapy.
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