ObjectiveTo systematically review the effectiveness and safety of taxanes combined with cisplatin and fluorouracil (TFP) versus cisplatin and fluorouracil (FP) for locally advanced head and neck squamous cell carcinoma. MethodsDatabases such as The Cochrane Library (Issue 1, 2013), PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data were electronically searched to collect randomized controlled trials (RCTs) about taxanes combined with cisplatin and fluorouracil in the treatment of locally advanced head and neck squamous cell carcinoma from the date of their establishment to April 1st, 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 7 RCTs involving 2 088 patients were included. The TFP group included 1 051 cases, while the FP group included 1 037 cases. The results of meta-analyses showed that, there were significant differences between the two groups in the 1-year, 2-year, and 3-year overall survival rates (RR=1.12, 95%CI 1.02 to 1.23, P=0.02; RR=1.20, 95%CI 1.11 to 1.29, P < 0.000 01; RR=1.18, 95%CI 1.07 to 1.31, P=0.000 7), the 1-year, 2-year, and 3 year of progressions free survival (RR=1.18, 95%CI 1.08 to 1.28, P=0.000 2; RR=1.20, 95%CI 1.06 to 1.36, P=0.003; RR=1.48, 95%CI 1.25 to 1.74, P < 0.000 01), the complete remission rate (RR=1.67, 95%CI 1.26 to 2.23, P=0.000 4), and the overall response to chemotherapy (RR=1.18, 95%CI 1.11 to 1.27, P < 0.000 01). As for the side effect, the FP group was superior to the TFP group in the neutropenia (RR=1.42, 95%CI 1.24 to 1.63, P < 0.000 01), alopecia (RR=16.09, 95%CI 4.59 to 56.38, P < 0.000 1), and febrile neutropenia (RR=2.21, 95%CI 1.29 to 3.80, P < 0.004). ConclusionThe fluorouracil with cisplatin and fluorouracil for advanced head and neck squamous cell carcinoma might have better effects, but with higher side effects.