Objective:

To systematically compare the relative efficacy of induction chemotherapy, targeted therapy, and radiotherapy on overall survival and treatment response in nasopharyngeal carcinoma (NPC) patients.

Approach:

• Study Design: Systematic review and network meta-analysis of randomized controlled trials (RCTs) following PRISMA-NMA and Cochrane Manual guidelines.
• Data Sources: Search conducted across six databases (PubMed, Embase, Web of Science, Cochrane Library, EBSCO, and CNKI) for RCTs published from January 1998 to June 2025.
• Analysis Methods: Traditional meta-analysis and heterogeneity assessment using RevMan 5.3; network meta-analysis using STATA 17.0.

Key Findings:

• Induction chemotherapy (IC) showed a statistically significant survival benefit compared to the control group (HR = 0.37, 95% CI: 0.02, 0.71).
• Targeted therapy (TD) ranked first in the probability of being the best treatment for overall survival (SUCRA = 98.1%).
• No statistically significant differences were observed among interventions for progression-free survival (PFS) or objective response rate (ORR).
• TD demonstrated the greatest advantage in cumulative recurrence risk reduction (SUCRA = 98.0%, OR = 0.26, 95% CI: 0.12, 0.58).

Interpretation:

Induction chemotherapy offers the greatest advantage in improving overall survival for NPC patients, while targeted drugs are most effective in reducing recurrence risk.

Limitations:

• The study only included RCTs published up to June 2025, which may limit the generalizability of findings.
• No statistically significant benefits were observed for PFS or ORR among the interventions.

Conclusion:

This study provides evidence-based support for individualized treatment decisions in nasopharyngeal carcinoma.

Sources:

• Systematic Review Registration