Gemcitabine and cisplatin regimen facilitates prognosis of advanced nasopharyngeal carcinoma

This study was conducted to assess the efficacy and adverse effects of GP (gemcitabine+cisplatin) regimen and FP (fluouracil+cisplatin) regimen in treatment of advanced nasopharyngeal carcinoma. Systematic online searches were performed in PubMed, Web of Sciences, China Knowledge Infrastructure and Weipu from the inception to November 15, 2017. Potential studies were assessed using the Cochrane risk of bias scale. Statistical analyses were performed on Stata 14.0 and RevMan 5.3. Finally, twelve studies entered final qualitative synthesis and quantitative analysis. The GP regimen compared with the FP regimen had significantly higher 1-year survival rate (relative risk (RR)=1.07, 95% confidence interval (CI): 1.01-1.13), significantly better performance in the fixed-effect model (RR=1.16, 95%CI: 1.04-1.30) and significantly higher remission rate (RR=1.17, 95%CI: 1.05-1.29). Significant differences between regimens were found in gastrointestinal effects (RR=0.58, 95%CI: 0.45-0.74). No significant differences between regimens were found in reduced hemoglobin rate (RR=0.55, 95%CI: 0.36-1.21), neutropenia (RR=1.84, 95%CI: 0.93-5.02), or reduced platelet (RR=1.25, 95%CI: 0.85-1.75) and mucosal inflammation (RR=0.81, 95%CI: 0.57-1.16). Sensitivity analysis indicated the results remained stable. The funnel plot indicated some publication bias. In conclusion, the GP regimen outperforms the FP regimen in treatment of advanced nasopharyngeal carcinoma with no difference in adverse effects. We may consider the GP regimen a better choice, but this conclusion should be confirmed by high-quality trials.