AustralieFrV1, Main, Exploration, bibRecord, 005B76

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Identifieur interne : 005B76 ( Main/Exploration ); précédent : 005B75; suivant : 005B77

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Auteurs : Audrey Mauguen [France] ; Cécile Le Pechoux [France] ; Michele I. Saunders [Royaume-Uni] ; Steven E. Schild [États-Unis] ; Andrew T. Turrisi [États-Unis] ; Michael Baumann [Allemagne] ; William T. Sause [Australie] ; David Ball [Australie] ; Chandra P. Belani [États-Unis] ; James A. Bonner [États-Unis] ; Aleksander Zajusz [Pologne] ; Suzanne E. Dahlberg [États-Unis] ; Matthew Nankivell [Royaume-Uni] ; Sumithra J. Mandrekar [États-Unis] ; Rebecca Paulus [États-Unis] ; Katarzyna Behrendt [Pologne] ; Rainer Koch [Allemagne] ; James F. Bishop [Australie] ; Stanley Dische ; Rodrigo Arriagada [France, Suède] ; Dirk De Ruysscher [Pays-Bas] ; Jean-Pierre Pignon [France]

Source :

Journal of clinical oncology [ 0732-183X ] ; 2012.

RBID : Pascal:12-0331397

Descripteurs français

Pascal (Inist)
- Radiothérapie, Traitement, Cancer du poumon, Homme, Analyse donnée, Métaanalyse, Cancérologie.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Cancerology, Data analysis, Human, Lung cancer, Metaanalysis, Radiotherapy, Treatment.

Abstract

Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR ₌ 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934452

Affiliations:

Allemagne, Australie, France, Pays-Bas, Pologne, Royaume-Uni, Suède, États-Unis
Angleterre, District de Dresde, Grand Londres, Saxe (Land), Svealand, Victoria (État)
Dresde, Londres, Melbourne, Stockholm
Université de Melbourne

Le document en format XML

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<country>Australie</country>
<wicri:noRegion>Intermountain Medical Center</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ball, David" sort="Ball, David" uniqKey="Ball D" first="David" last="Ball">David Ball</name>
<affiliation wicri:level="4"><inist:fA14 i1="08"><s1>University of Melbourne, East Melbourne</s1>
<s2>Victoria</s2>
<s3>AUS</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<wicri:noRegion>Victoria</wicri:noRegion>
<orgName type="university">Université de Melbourne</orgName>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Belani, Chandra P" sort="Belani, Chandra P" uniqKey="Belani C" first="Chandra P." last="Belani">Chandra P. Belani</name>
<affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Penn State Milton S. Hershey Medical Center</s1>
<s2>Hershey</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Penn State Milton S. Hershey Medical Center</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bonner, James A" sort="Bonner, James A" uniqKey="Bonner J" first="James A." last="Bonner">James A. Bonner</name>
<affiliation wicri:level="1"><inist:fA14 i1="12"><s1>University of Alabama-Birmingham</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>University of Alabama-Birmingham</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Zajusz, Aleksander" sort="Zajusz, Aleksander" uniqKey="Zajusz A" first="Aleksander" last="Zajusz">Aleksander Zajusz</name>
<affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch</s1>
<s3>POL</s3>
<sZ>11 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Pologne</country>
<wicri:noRegion>Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Dahlberg, Suzanne E" sort="Dahlberg, Suzanne E" uniqKey="Dahlberg S" first="Suzanne E." last="Dahlberg">Suzanne E. Dahlberg</name>
<affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Dana-Farber Cancer Institute</s1>
<s2>Boston, MA</s2>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Dana-Farber Cancer Institute</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nankivell, Matthew" sort="Nankivell, Matthew" uniqKey="Nankivell M" first="Matthew" last="Nankivell">Matthew Nankivell</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Medical Research Council Clinical Trials Unit</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mandrekar, Sumithra J" sort="Mandrekar, Sumithra J" uniqKey="Mandrekar S" first="Sumithra J." last="Mandrekar">Sumithra J. Mandrekar</name>
<affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Mayo Clinic and North Central Cancer Treatment Group</s1>
<s2>Rochester, MN</s2>
<s3>USA</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Mayo Clinic and North Central Cancer Treatment Group</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Paulus, Rebecca" sort="Paulus, Rebecca" uniqKey="Paulus R" first="Rebecca" last="Paulus">Rebecca Paulus</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Radiation Therapy Oncology Group</s1>
<s2>Philadelphia, PA</s2>
<s3>USA</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Radiation Therapy Oncology Group</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Behrendt, Katarzyna" sort="Behrendt, Katarzyna" uniqKey="Behrendt K" first="Katarzyna" last="Behrendt">Katarzyna Behrendt</name>
<affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch</s1>
<s3>POL</s3>
<sZ>11 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Pologne</country>
<wicri:noRegion>Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Koch, Rainer" sort="Koch, Rainer" uniqKey="Koch R" first="Rainer" last="Koch">Rainer Koch</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>University Hospital and Medical Faculty Carl Gustav Carus</s1>
<s2>Dresden</s2>
<s3>DEU</s3>
<sZ>6 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName><region type="land" nuts="1">Saxe (Land)</region>
<region type="district" nuts="2">District de Dresde</region>
<settlement type="city">Dresde</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bishop, James F" sort="Bishop, James F" uniqKey="Bishop J" first="James F." last="Bishop">James F. Bishop</name>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Victorian Comprehensive Cancer Centre</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Dische, Stanley" sort="Dische, Stanley" uniqKey="Dische S" first="Stanley" last="Dische">Stanley Dische</name>
</author>
<author><name sortKey="Arriagada, Rodrigo" sort="Arriagada, Rodrigo" uniqKey="Arriagada R" first="Rodrigo" last="Arriagada">Rodrigo Arriagada</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Villejuif</wicri:noRegion>
<wicri:noRegion>Institut de Cancérologie Gustave-Roussy</wicri:noRegion>
<wicri:noRegion>Institut de Cancérologie Gustave-Roussy</wicri:noRegion>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="16"><s1>Karolinska Institutet</s1>
<s2>Stockholm</s2>
<s3>SWE</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>Suède</country>
<placeName><settlement type="city">Stockholm</settlement>
<region nuts="2">Svealand</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ruysscher, Dirk De" sort="Ruysscher, Dirk De" uniqKey="Ruysscher D" first="Dirk De" last="Ruysscher">Dirk De Ruysscher</name>
<affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Maastricht University Medical Center</s1>
<s2>Maastricht</s2>
<s3>NLD</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
<wicri:noRegion>Maastricht University Medical Center</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Pignon, Jean Pierre" sort="Pignon, Jean Pierre" uniqKey="Pignon J" first="Jean-Pierre" last="Pignon">Jean-Pierre Pignon</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Villejuif</wicri:noRegion>
<wicri:noRegion>Institut de Cancérologie Gustave-Roussy</wicri:noRegion>
<wicri:noRegion>Institut de Cancérologie Gustave-Roussy</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cancerology</term>
<term>Data analysis</term>
<term>Human</term>
<term>Lung cancer</term>
<term>Metaanalysis</term>
<term>Radiotherapy</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Radiothérapie</term>
<term>Traitement</term>
<term>Cancer du poumon</term>
<term>Homme</term>
<term>Analyse donnée</term>
<term>Métaanalyse</term>
<term>Cancérologie</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR <sub>=</sub>
 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.</div>
</front>
</TEI>
<affiliations><list><country><li>Allemagne</li>
<li>Australie</li>
<li>France</li>
<li>Pays-Bas</li>
<li>Pologne</li>
<li>Royaume-Uni</li>
<li>Suède</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>District de Dresde</li>
<li>Grand Londres</li>
<li>Saxe (Land)</li>
<li>Svealand</li>
<li>Victoria (État)</li>
</region>
<settlement><li>Dresde</li>
<li>Londres</li>
<li>Melbourne</li>
<li>Stockholm</li>
</settlement>
<orgName><li>Université de Melbourne</li>
</orgName>
</list>
<tree><noCountry><name sortKey="Dische, Stanley" sort="Dische, Stanley" uniqKey="Dische S" first="Stanley" last="Dische">Stanley Dische</name>
</noCountry>
<country name="France"><noRegion><name sortKey="Mauguen, Audrey" sort="Mauguen, Audrey" uniqKey="Mauguen A" first="Audrey" last="Mauguen">Audrey Mauguen</name>
</noRegion>
<name sortKey="Arriagada, Rodrigo" sort="Arriagada, Rodrigo" uniqKey="Arriagada R" first="Rodrigo" last="Arriagada">Rodrigo Arriagada</name>
<name sortKey="Le Pechoux, Cecile" sort="Le Pechoux, Cecile" uniqKey="Le Pechoux C" first="Cécile" last="Le Pechoux">Cécile Le Pechoux</name>
<name sortKey="Pignon, Jean Pierre" sort="Pignon, Jean Pierre" uniqKey="Pignon J" first="Jean-Pierre" last="Pignon">Jean-Pierre Pignon</name>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Saunders, Michele I" sort="Saunders, Michele I" uniqKey="Saunders M" first="Michele I." last="Saunders">Michele I. Saunders</name>
</noRegion>
<name sortKey="Nankivell, Matthew" sort="Nankivell, Matthew" uniqKey="Nankivell M" first="Matthew" last="Nankivell">Matthew Nankivell</name>
</country>
<country name="États-Unis"><noRegion><name sortKey="Schild, Steven E" sort="Schild, Steven E" uniqKey="Schild S" first="Steven E." last="Schild">Steven E. Schild</name>
</noRegion>
<name sortKey="Belani, Chandra P" sort="Belani, Chandra P" uniqKey="Belani C" first="Chandra P." last="Belani">Chandra P. Belani</name>
<name sortKey="Bonner, James A" sort="Bonner, James A" uniqKey="Bonner J" first="James A." last="Bonner">James A. Bonner</name>
<name sortKey="Dahlberg, Suzanne E" sort="Dahlberg, Suzanne E" uniqKey="Dahlberg S" first="Suzanne E." last="Dahlberg">Suzanne E. Dahlberg</name>
<name sortKey="Mandrekar, Sumithra J" sort="Mandrekar, Sumithra J" uniqKey="Mandrekar S" first="Sumithra J." last="Mandrekar">Sumithra J. Mandrekar</name>
<name sortKey="Paulus, Rebecca" sort="Paulus, Rebecca" uniqKey="Paulus R" first="Rebecca" last="Paulus">Rebecca Paulus</name>
<name sortKey="Turrisi, Andrew T" sort="Turrisi, Andrew T" uniqKey="Turrisi A" first="Andrew T." last="Turrisi">Andrew T. Turrisi</name>
</country>
<country name="Allemagne"><region name="Saxe (Land)"><name sortKey="Baumann, Michael" sort="Baumann, Michael" uniqKey="Baumann M" first="Michael" last="Baumann">Michael Baumann</name>
</region>
<name sortKey="Koch, Rainer" sort="Koch, Rainer" uniqKey="Koch R" first="Rainer" last="Koch">Rainer Koch</name>
</country>
<country name="Australie"><noRegion><name sortKey="Sause, William T" sort="Sause, William T" uniqKey="Sause W" first="William T." last="Sause">William T. Sause</name>
</noRegion>
<name sortKey="Ball, David" sort="Ball, David" uniqKey="Ball D" first="David" last="Ball">David Ball</name>
<name sortKey="Bishop, James F" sort="Bishop, James F" uniqKey="Bishop J" first="James F." last="Bishop">James F. Bishop</name>
</country>
<country name="Pologne"><noRegion><name sortKey="Zajusz, Aleksander" sort="Zajusz, Aleksander" uniqKey="Zajusz A" first="Aleksander" last="Zajusz">Aleksander Zajusz</name>
</noRegion>
<name sortKey="Behrendt, Katarzyna" sort="Behrendt, Katarzyna" uniqKey="Behrendt K" first="Katarzyna" last="Behrendt">Katarzyna Behrendt</name>
</country>
<country name="Suède"><region name="Svealand"><name sortKey="Arriagada, Rodrigo" sort="Arriagada, Rodrigo" uniqKey="Arriagada R" first="Rodrigo" last="Arriagada">Rodrigo Arriagada</name>
</region>
</country>
<country name="Pays-Bas"><noRegion><name sortKey="Ruysscher, Dirk De" sort="Ruysscher, Dirk De" uniqKey="Ruysscher D" first="Dirk De" last="Ruysscher">Dirk De Ruysscher</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

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