Efficacy And Adverse Effects Of GP Regimen And FP Regimen In Treatment Of Advanced Nasopharyngeal Carcinoma : A Meta-analyses

Objective :Nasopharyngeal carcinoma is one of the most common of the head and neck cancer.Because of its unique pathologic type,radiation therapy has an important position.Most patients,s early symptoms and signs are not obvious,once the disease was diagnosised,most of them were in advanced stages.Distant metastasis and recurrence of nasopharyngeal carcinoma(NPC)have seriously affected the survival rate,which has became the main cause of treatment failure.How to improve the local control rates ?decrease the occurence of distant metastasis and recurrence and improve overall survival rate has become a top priority of the current treatment of nasopharyngeal carcinoma(NPC).For a long time,FP scheme(fluorouracil + cisplatin)as a standard first-line treatment of advanced nasopharyngeal carcinoma,however,there is no clear evidence of evidence-based medicine.In recent years,some studies have shown that GP plan may be an effective therapy for advanced nasopharyngeal carcinoma.So now we will evaluate the efficacy and adverse effects of GP(gemcitabine+cisplatin)regimen and FP(fluouracil+cisplatin)regimen in treatment of advanced nasopharyngeal carcinoma by meta-analyses.Methods :We search all relevant literature in network databases including Pub Med?The Cochane Library?EMbase?SCI?Medcine?Ovid?CBM?CNKI and VIP to July2016.The original articles about clinical randomized controlled trials comparing the chemotherapy of GP and FP regimen in treatment of advanced nasopharyngeal carcinoma were recruited from the databases.The quality of the eligible trials was assessed by Jadad-scale method.Rev Man5.3 software was used for meta-analyses.Results : Forteen studies involving 1253 patients were accorded with the inclusion criteria.The results of meta-analyses indicated that: in the aspect of efficacy,1-year-survival?3-year-survival and remission rates of GP were higher than FP regimen(RR=1.07,95%CI:1.01~1.13,p=0.03)?(RR=1.20,95%CI:1.07~1.33,p=0.001)?(RR=1.23,95%CI:1.09~1.40,p=0.0009);in the aspect of adverse effects : the hematology toxicity was similar(p?0.05);and the gastrointestinal reactions(nausea?vomiting)of GP regimen was relatively slighter(p<0.00001).Conclusion :GP regimen has better efficacy and slighter adverse effects compared with FP in treatment of advanced nasopharyngeal carcinoma.Maybe we can consider the GP regimen as a better choice,but we have to conform more high quality RCTS to confirm this conclusion.