Background: Induction chemotherapy with docetaxel. cisplatin, and 5FU (TPF) before radiotherapy or chemoradiation (RT-CHX) has been shown to improve overall survival compared to induction chemotherapy with cisplatin and 5 FU in locally advanced HNSCC. Whether TPF induction before chemoradiation improves clinical outcome in comparison to chemoradiation is still a matter of debate. Recently, the results of 4 randomized trials addressing this question have become available. Methods: In the 4 trials of interest, in total 802 patients with locally advanced HNSCC were randomly assigned to receive either TPF induction chemotherapy followed by concurrent RT-CHX or concurrent RT-CHX. Platin or taxane based chemotherapy was used during radiotherapy (2x1.5 Gy and 1.8- 2 Gy in 30-35 fractions). 416 had oropharyngeal, 114 hyopharyngeal, 78 laryngeal, 143 oral cavity and 52 other HNSCC. Published hazard ratios and hazard ratios extracted from available survival curves for overall survival (OS) and progression free survival (PFS) were basis of the meta-analysis. Meta-analysis of the effect sizes on OS and PFS was performed using a random effects model based on parameter estimates of log hazard ratios in Cox models and their standard errors. Results: Additional induction chemotherapy with TPF before RT-CHX did not result in an improvement of overall survival (Hazard Ratio: 1.008, 95% confidence limits (CL) 0.816-1.246, p=0.940). A modest and statistically not significant benefit was observed in terms of PFS (Hazard Ratio: 0.881, 95% CL 0.723-1.073, p=0.207). Conclusions: Additional induction chemotherapy with TPF before RT-CHX does not improve overall survival in HNSCC.