Surgery And Postoperative Radiotherapy Versus Chemoradiotherapy For Locally Advanced Oropharyngeal Cancer:A Meta-analysis

Objective: To compare surgery and postoperative radiotherapy(PORT)with the non-surgical combination of chemotherapy and radiation therapy(CRT)for locally advanced oropharyngeal cancer by conducting a meta-analysis.Methods: We searched PubMed,Embase,Cochrane,Medline,CNKI,WanFang,VIP up to November,2017.Rev Man5.3 software was used for Statistical analysis.Results: 1308 literatures was searched firstly,only 13 trials met the inclusion criteria and24576 patients in total(PORT 9539,CRT 15037).Meta-analysis showed that: 3-year overall survival rate(OR:1.45,95%CI:0.89-2.36,Z=1.50,P=0.13),5-year overall survival rate(OR:1.07,95%CI:0.59-1.91,Z=0.22,P=0.83),3-year recurrence-free survival rate(OR:0.98,95%CI:0.67-1.44,Z=0.08,P=0.94),5-year recurrence-free survival rate(OR:0.81,95%CI:0.56-1.18,Z=1.10,P=0.27),3-year local control rate(OR:1.65,95%CI:0.66-4.13,Z=1.08,P=0.28)and 5-year disease-specific survival rate(OR: 0.98,95%CI:0.25-3.76,Z=0.03,P=0.98>0.05)showed no significant differences between surgery and postoperative radiotherapy(PORT)with chemoradiotherapy.Conclusions: There was no difference in the long-term survival of locally advanced oropharyngeal cancer between the two methods of surgery combined with postoperative radiotherapy and chemoradiotherapy.Further prospective randomized trials are required to validate our findings.We suggested that chemoradiotherapy is the first choice for locally advanced oropharyngeal cancer.If it fails,salvage surgery is performed.Further randomized trials are required to validate our findings.