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Table 3 Subgroup analysis and sensitivity analysis of ILNSI versus ILNPI

From: 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

Outcomes

No. of studies

Pts receiving ILNSI (no.)

Pts receiving ILNPI (no.)

All pts. (no.)

HR/OR (95% CI)

P

Study heterogeneity

χ2

df

I2 (%)

P

Subgroup analysis

 Studies using IMRT

  3-year OS

2

360

456

816

1.10 (0.69,1.74)

0.68

0.20

1

0

0.65

  3-year RRFS

3

414

556

970

1.11 (0.50,2.49)

0.80

1.26

2

0

0.53

  3-year DFS

2

243

457

700

0.92 (0.64,1.33)

0.67

26

1

26

0.24

  3-year DMFS

3

414

556

970

0.97 (0.62,1.51)

0.88

3.85

2

48

0.15

  ILN recurrence

3

414

556

970

1.44 (0.35,5.95) a

0.62

3.12

2

36

0.21

 Studies using 2D-RT

  3-year OS

2

176

207

383

1.35 (0.79,2.30)

0.27

0.29

1

0

0.59

  3-year DFS

2

176

207

383

1.41 (0.87,2.30)

0.17

0.15

1

0

0.70

  ILN recurrence

2

176

207

383

1.17 (0.16,8.32) a

0.88

0.02

1

0

0.90

Sensitivity analysis

 English publications

  3-year OS

4

602

634

1236

1.07 (0.73,1.57)

0.73

1.69

3

0

0.64

  3-year RRFS

5

571

1128

1699

1.27 (0.69,2.33)

0.44

2.48

4

0

0.65

  3-year DFS

2

243

457

700

0.92 (0.64,1.33)

0.67

26

1

26

0.24

  3-year DMFS

6

693

835

1528

1.00 (0.69,1.44)

0.99

3.98

5

0

0.55

  ILN recurrence

7

761

1377

2138

0.95 (0.44,2.09) a

0.91

5.64

6

0

0.46

 High-quality studies

  3-year OS

4

519

652

1171

1.02 (0.69,1.52)

0.92

1.44

3

0

0.70

  3-year RRFS

5

488

1146

1634

1.29 (0.71,2.37)

0.41

2.99

4

0

0.56

  3-year DFS

3

331

574

905

0.95 (0.67,1.34)

0.78

1.58

2

0

0.45

  3-year DMFS

4

485

635

1120

0.92 (0.62,1.36)

0.68

1.49

3

0

0.69

  ILN recurrence

6

641

1291

1932

1.05 (0.46,2.42) a

0.90

4.14

5

0

0.53

 Studies matched for T category

  3-year OS

5

689

811

1500

1.13 (0.82,1.55)

0.44

1.41

4

0

0.84

  3-year RRFS

5

570

1215

1785

1.20 (0.63,2.29)

0.54

2.81

4

0

0.59

  3-year DFS

4

419

664

1083

1.08 (0.80,1.44)

0.62

3.37

3

11

0.34

  3-year DMFS

5

604

805

1409

0.98 (0.67,1.44)

0.93

3.87

4

0

0.42

  ILN recurrence

7

811

1453

2264

1.06 (0.49,2.33) a

0.88

3.39

6

0

0.76

 Studies detecting LN metastases mainly by MRI

  3-year OS

4

602

634

1236

1.07 (073,1.57)

0.73

1.69

4

0

0.64

  3-year RRFS

4

503

586

1089

1.37 (0.68,2.76)

0/38

2.31

3

0

0.51

  3-year DFS

4

419

664

1083

1.08 (0.80,1.44)

0.62

3.37

3

11

0.34

  3-year DMFS

6

693

835

1528

1.00 (0.69,1.44)

0.99

3.98

5

0

0.55

  ILN recurrence

6

693

835

1528

1.05 (0.37,2.96) a

0.93

5.58

5

10

0.35

  1. Abbreviations: No. number, pts. patients, HR hazard radio, ILNSI ipsilateral lower neck sparing irradiation, ILNPI ipsilateral lower neck prophylactic irradiation, ILN ipsilateral lower neck, OS overall survival, RRFS regional recurrence-free survival, DFS disease-free survival, DMFS distant metastasis-free survival, MRI magnetic resonance imaging, CT computed tomography, IMRT intensity-modulated radiation therapy, 2D-RT two-dimensional radiotherapy
  2. a OR