OBJECTIVE: To systematically review the efficacy and safety of taxane, cisplatin, and fluorouracil (Tax-PF) as induction chemotherapy for advanced head and neck cancer. METHOD: Literature about the efficacy and safety of Taxane-cisplatin-fluorouracil as induction chemotherapy for advanced head and neck cancer was retrieved from digital databases of PubMed, Embase, SpringerLink, MEDLINE and the Cochrane Library before February 2015. Data extraction and quality assessment of included studies were conducted by two reviewers independently. Stata 13.0 was then used to perform Meta-analysis. RESULT: A total 7 randomized controlled trials involving 2,702 were included. The 3-year OS rate [HR = 1.14, 95% CI (1.03, 1.25), P < 0.01], 3-year PFS rate [HR = 1.24, 95% CI (1.08, 1.43), P < 0.01], 5-year OS rate [HR = 1.30, 95% CI (1.09, 1. 55), P < 0. 01], 5-year PFS rate [HR = 1.39, 95% CI (1.14, 1.70), P < 0.01] and ORR to chemotherapy [OR = 1.66, 95% CI (1.35, 2.05), P < 0.01] of the patients in the Tax-PF group were statistically superior to those in the PF group. In terms of toxicities, the incidence of febrile neutropenia [OR = 2.36, 95% CI (1.62, 3.46), P < 0.01], alopecia [OR = 8.22, 95% CI (3.99, 16.92), P < 0.01], diarrhea [OR = 1.57, 95% CI (1.05, 2.36), P< 0.05] and leucopenia [OR = 2.79, 95% CI (1.86, 4.21), P < 0.01] was higher in the Tax-PF group than that in the PF group. CONCLUSION The Tax-PF induction chemotherapy improved PFS and OS, and the ORR was better as compared to PF-based therapy regimens at the cost of a higher incidence of adverse events.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bridged-Ring Compounds ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Head and Neck Neoplasms ; drug therapy ; Humans ; Induction Chemotherapy ; Randomized Controlled Trials as Topic ; Taxoids ; therapeutic use

Objective To systematically review the efficacy of corticosteroid nasal spray plus antihistamine versus either therapy given alone or placebo in patients with allergic rhinitis (AR).Methods The PubMed, EMbase, Google Scholar and The Cochrane Library were electronically searched for randomized controlled trials ( RCTs ) about the efficacy of corticosteroid plus antihistamine for AR .The duration of the search was from the inception of the databases to April 2015 . After literature selection , data extraction and quality assessment conducted by two reviewers independently , meta-analysis was conducted using RevMan 5.3 software.Results Ten studies involving 6568 patients were finally included .The qualitative analysis showed that the combination therapy had greater efficacy than oral antihistamines alone or placebo on improving symptoms.The results of meta-analysis showed that pooled results of two trials failed to show significant difference in total nasal symptoms between combination therapy and intranasal corticosteroid alone [ WMD =-0.20, 95%CI (-0.38,-0.01),P=0.04].The cumulative meta-analysis of six RCTs showed that the combination therapy was superior to intranasal corticosteroid alone[WMD=-1.16, 95%CI( -1.49,-0.83), P<0.00001], intranasal antihistamine alone[WMD=-1.73, 95%CI( -2.08,-1.38),P<0.00001], and placebo [WMD =-2.81, 95%CI( -3.16,-2.47), P<0.00001].Conclusion Intranasal corticosteroid plus oral antihistamine has similar efficacy to intranasal corticosteroid alone, greater efficacy than oral antihistamines alone or placebo in reducing nasal symptoms for AR patients . Intranasal corticosteroid plus intranasal antihistamine is significantly superior to either therapy given alone or placebo .

Objective:To evaluate the cost-effectiveness of hepatitis C screening in general population in China, and find the age group in which hepatitis C screening can achieve the best cost-effectiveness.Methods:A decision-Markov model was constructed by using software TreeAge pro 2019 to simulate the outcomes of hepatitis C disease pregression of 100 000 persons aged 20-59 years. The cost-effectiveness of the strategies were evaluated from societal perspectives by using incremental cost-effectiveness ratio (ICER) and net monetary benefit (NMB). One-way sensitivity analysis and probability sensitivity analysis were used to evaluate the uncertainty of parameters and model.Results:Hepatitis C screening was cost-effective in people aged 20- 59 years and the cost effectiveness was best in age group 40-49 years. Compared with non-screening strategy of hepatitis C in people aged 20-59 years, the incremental cost was 161.24 yuan, the incremental utility was 0.003 6 quality adjusted life years (QALYs)/per person, ICER was 45 197.26 yuan/QALY, ICER was less than the willing payment threshold. The ICER and NMB in all age groups were 42 055.06-53 249.43 yuan/QALY and 96.52-169.86 yuan/per person. Hepatitis C screening in people aged 40-49 years had the best cost-effectiveness. The results of one-way sensitivity analysis showed that the discount rate, anti-HCV detection cost, anti-HCV infection rate and the cost of direct antiviral agents were the main factors influencing economic evaluation. The results of the probability sensitivity analysis indicated that the model analysis was stable.Conclusions:Implementing hepatitis C screening based on medical institutions is cost-effective in people aged 20- 59 years, especially in those aged 40-49 years. Implementing the HCV screening strategy of be willing to test as far as possible in general population can reduce hepatitis C disease burden in China.