Meta-analysis of efficacy of Chinese medicine compound combined with concurrent radiotherapy and chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma

Background: Nasopharyngeal carcinoma is a prevalent malignant tumor in clinical practice, with the highest incidence rate among otorhinolaryngological malignant tumors. Objectives: This study aims to comprehensively evaluate the clinical efficacy and safety of traditional Chinese medicine compound (CMC) combined with concur-rent radiotherapy and chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma (LA-NPC). Methods: Relevant essays published before November 20, 2021, were retrieved from China National Knowledge Internet (CNKI), China Science and Technology Journal Database (CQVIP), Wanfang database, PubMed, and Web of Science databases. Randomized controlled trials regarding the clinical efficacy of CMC combined with concur-rent radiotherapy and chemotherapy in the treatment of LA-NPC were included. Results: A total of 15 publications involving 1324 patients were included in this study, including 665 in the experimental group and 659 in the control group. Meta-analyses revealed that compared with radiotherapy or chemotherapy only, CMC combined with con-current radiotherapy and chemotherapy for LA-NPC significantly improved the efficacy [risk ratio (RR)=1.15, 95% confidence interval (95% CI) (1.09, 1.20), P<0.00001], the quality of life [RR=1.35, 95% CI (1.13, 1.62), P=0.0009], immune function indices CD4+ levels [RR=6.2, 95% CI (3.64, 8.76), P<0.00001], CD4+/CD8+ [RR=0.33, 95% CI (0.14, 0.53), P=0.0009], and alleviated the decrease in white blood cell counts [RR=0.67, 95% CI (0.52, 0.86), P=0.002]. Conclusion: CMC combined with concurrent radiotherapy and chemotherapy for the treatment of LA-NPC can significantly improve the efficacy and reduce severe adverse reactions caused by conventional radiotherapy and chemotherapy. However, due to limitations in the quantity and quality of the included studies, more high-quality, multi-center, and large sample-size studies are needed to provide high-level and high-quality medical evidence for systematic evaluation.