NDLI: Feasibility of ipsilateral lower neck sparing irradiation for unilateral or bilateral neck node-negative nasopharyngeal carcinoma: systemic review and meta-analysis of 2, 521 patients

Content Provider	Springer Nature : BioMed Central
Author	Huang, Cheng-Long Xu, Cheng Zhang, Yuan Zhou, Guan-Qun Mao, Yan-Ping Liu, Qing Sun, Ying Ma, Jun Tang, Ling-Long
Abstract	Background To compare the efficacy of ipsilateral lower neck sparing irradiation (ILNSI) versus ipsilateral lower neck prophylactic irradiation (ILNPI) for unilateral or bilateral neck node-negative nasopharyngeal cancer (NPC). Methods A comprehensive literature search of PubMed, EMBASE, the Cochrane Library and other public databases was conducted in October, 2017. The outcomes were 3-year overall/regional recurrence-free/disease-free/distant metastasis-free survival (OS/RRFS/DFS/DMFS) and ipsilateral lower neck (ILN) recurrence. We performed subgroup analysis of ILNSI versus ILNPI for different radiotherapy techniques. Sensitivity analysis was performed to examine the stability of the results. Results Nine head-to-head comparative studies (2, 521 patients) were included in the meta-analysis. For the comparison of ILNSI versus ILNPI, there was no significant difference in 3-year OS (HR = 1.16, 95% confidence interval [CI] = 0.85–1.58, P = 0.36), RRFS (HR = 1.37, 95% CI = 0.76–2.47, P = 0.30), DFS (HR = 1.08, 95% CI = 0.80–1.44, P = 0.62) and DMFS (HR = 1.00, 95% CI = 0.69–1.44, P = 0.99). ILNSI and ILNPI also led to equivalent ILN recurrence rates (OR = 0.98, 95% CI = 0.47–2.03, P = 0.96). No significant heterogeneity was observed for any outcome. Subgroup analysis confirmed no significant differences between ILNSI and ILNPI for any outcome, regardless of radiotherapy technique. Sensitivity analysis indicated all outcomes were highly stable in favor of the original conclusions. Conclusions ILNSI provided equivalent survival outcomes and regional control compared to ILNPI; ILNSI represents an appropriate alternative strategy for patients with unilateral or bilateral neck node-negative NPC.
Related Links	https://ro-journal.biomedcentral.com/counter/pdf/10.1186/s13014-018-1087-x.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13014-018-1087-x
Journal	Radiation Oncology
Issue Number	1
Volume Number	13
Language	English
Publisher	BioMed Central
Publisher Date	2018-08-06
Access Restriction	Open
Subject Keyword	Cancer Research Oncology Radiotherapy Imaging Radiology Nasopharyngeal carcinoma Lymph node metastases Ipsilateral lower neck sparing irradiation Ipsilateral lower neck prophylactic irradiation Survival
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Oncology
Journal Impact Factor	3.3/2023
5-Year Journal Impact Factor	3.6/2023

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