The literature was searched using MEDLINE (OVID; 1966 through October 2004), EMBASE (OVID; 1980 through October 2004), the Cochrane Library (OVID; Issue 3, 2004), the Physician Data Query database, the Canadian Medical Association Infobase, and the National Guideline Clearinghouse, as well as abstracts published in the proceedings of the meetings of the American Society of Clinical Oncology (1997-2004), the American Society for Therapeutic Radiology and Oncology (1992-2004), the Asian Clinical Oncology Society (2001), the International Congress of Radiation Oncology (1997 and 2001), the European Society of Therapeutic Radiology and Oncology (1992, 1994, 1996, 1998, 2000, 2002), and the European Society for Medical Oncology (2000, 2002). Article bibliographies and personal files were also searched for evidence relevant to this report.
The literature search combined nasopharyngeal disease specific terms (nasopharyngeal neoplasms/ or nasopharyn:.mp. or nasopharyngeal.tw.) with treatment specific terms (drug therapy/ or chemotherapy/ or chemotherapy.tw. or radiochemotherapy.mp. or chemoradiotherapy.mp.) and search specific terms for the following: practice guidelines, systematic reviews, meta-analyses, and randomized controlled trials.
Inclusion Criteria
Articles were selected for inclusion in this systematic review of the evidence if they were published reports or published abstracts of randomized controlled trials that reported the following:
- Data on the treatment population of interest (i.e., newly diagnosed patients with locally advanced squamous cell or undifferentiated nasopharyngeal cancer)
- Data on patients receiving any combination of chemotherapy plus radiation in the neoadjuvant, concurrent, or adjuvant setting (intervention) versus radiotherapy alone (control)
- Results for the primary outcomes of interest: disease-free survival and/or overall survival, or for the secondary outcomes of interest: local control, response, toxicity, and/or quality of life
Practice guidelines, meta-analyses, or systematic reviews explicitly based on randomized trials related to the guideline question were also eligible for inclusion in the systematic review.
Exclusion Criteria
Articles were excluded from the systematic review of the evidence if they:
- Were trials that did not report separate results for patients with nasopharyngeal cancer
- Were trials reported in a language other than English where data could not be extracted